The clinical characteristics of intraoral herpes simplex virus infection in 52 immunocompetent patients

Objective. Intraoral herpes simplex virus infection is commonly mistaken for recurrent aphthous stomatitis. The purpose of this study was to describe the clinical features of intraoral herpes simplex virus infection. Study design. Fifty-two immunocompetent patients with culture-positive intraoral herpes simplex Virus infection were studied. Results. The median age of the patients was 42 years. One third of the patients exhibited single ulcers; the remaining patients displayed multiple lesions. In 47 of 52 cases, the ulcers occurred on keratinized surfaces of the oral cavity; however, 5 patients had persistent ulcerations on nonkeratinized mucosa, a typical feature of herpetic ulcers in immunosuppressed patients. Of 27 patients with histories of recurrences, 22 were previously incorrectly diagnosed with recurrent aphthous stomatitis. Conclusions. Herpes simplex virus infection of the oral cavity can usually be differentiated from other causes of recurrent oral ulcerations on the basis of its clinical appearance and distribution. The recognition of atypical features may prevent unnecessary and costly treatments for unrelated though clinically similar-appearing disorders.