1-44. PRIMARY HERPETIC GINGIVOSTOMATITIS
Initial exposure to the herpes simplex virus results in a generalized oral
inflammation followed by vesicle formation and subsequent ulceration. Systemic
symptoms of generalized illness accompany this initial attack. Most individuals have
their primary exposure to this virus as infants; however, this disease may also occur in
young adults and elderly patients. This condition is contagious. Healing occurs
spontaneously with the virus remaining in the nerve tissue, lying dormant in a latent
form. Future recurrence of the condition may be either intraoral or extraoral.
1-45. RECURRENT HERPES SIMPLEX: SECONDARY HERPETIC LESIONS
The herpes simplex virus may be reactivated (recurrent) in an extraoral form on
the lips or, inside the mouth, in an intraoral form.
a. Extraoral Herpes. Cold sore blisters, also called herpes labialis (figure 1-8),
are often associated with colds, trauma, fatigue, fevers, and prolonged exposure to the
sun and the wind. The common site of occurrence is on the lips at the border with the
skin of the face (called the vermilion border). The lesions usually consist of clusters of
small vesicles that, in the early stage, contain a clear, transparent fluid. After a few
hours, the vesicles rupture and form a crust or scab. The disease is self-limiting and
usually disappears in 10 to 14 days. The individual is infective until complete healing
Cold sore blisters on the upper lip of this patient are caused by the herpes
simplex virus. This recurring infection may be activated by prolonged
exposure to sunlight and/or wind.
Figure 1-8. Extraoral herpes.