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What is it about ?
These are infections, caused by different types of viruses, which cause lesions on the lips, tongue, palate, mucous membranes of the cheeks and throat.
What is their frequency?
the cold sore (cold sore) is common. It is also estimated that 5 to 7 people out of 10 would be carriers of the virus responsible for the disease without developing a cold sore. The number of new cases per year is estimated at 1.6 per 1,000 people.
Almost all of the children do varicella.
Three consultations with the general practitioner out of 1000 are motivated by a shingles or “ring of fire”, a manifestation of infection with the herpes zoster virus; in 15-20% of cases it manifests in the head and neck area. Shingles is seen more frequently in older people.
Infection with papillomavirus human (HPV) oral mucosa affects 4 people than 1000.
How to recognize them?
Sore
The “cold sore” (cold sore) is caused by the herpes simplex virus (HSV) type 1.
Infection with HSV-1 usually occurs in childhood, through direct contact with the skin or mucous membranes (for example during a kiss) or from contaminated objects (for example by drinking from the glass of a person who has a cold sore). This infection (primary infection) does not cause (many) complaints. Among those infected, 1 in 100 will develop significant bullous inflammation of the oral mucosa, accompanied by fever.
The virus remains in the body for life. He’s sort of in hibernation (latent) into an infected nerve.
The virus can be roused from sleep by UV rays (for example the solarium or excessive exposure to the sun), fever, a cold, treatments that weaken the immune system, stress, fatigue, menstruation and injury local. It then manifests itself in the form of a sore. This is a rash that recurs regularly on the lips and oral mucosa. The rash is preceded and accompanied by a painful burning sensation. A vesicle appears on a red background. It then dries up and forms a crust. The cold sore heals spontaneously in 8 to 10 days. In the mouth, the vesicles tear easily. This results in superficial ulcers, which heal spontaneously after 1 to 2 weeks without leaving scars.
Chickenpox and shingles
The varicella and the shingles are caused by the herpes zoster virus.
Infection occurs in childhood and causes varicella. Blisters can appear anywhere on the body, and on the lining of the mouth, most often on the palate. At first, the vesicles are filled with a transparent aqueous liquid. After ten days, the vesicles dry out and form crusts. The disease resolves spontaneously.
The virus remains in the body for life. He’s sort of in hibernation (latent) into an infected nerve.
the shingles of the mouth occurs more often in older people, and often in people who have had chickenpox as a child. The infection can start with a toothache. After a few days, small blisters form in and around the mouth. Most often, the blisters are confined to one half of the body, except in the palate. Sometimes it happens that unpleasant pain persists after healing.
Herpangina and foot-hand-mouth syndrome
THE’herpangina is caused by a enterovirus, more specifically a Coxsackie virus.
This virus strikes by epidemics, especially children. General symptoms appear before the rash in the mouth; these are fever, malaise, headache, abdominal and muscle pain. Then, vesicles appear with a pale ring, usually on the palate, uvula and tonsils. Unlike rash infections caused by HSV, there are no blisters on the gums. The lesions are also less painful and last a shorter time.
the hand-foot-mouth syndrome is also caused by an enterovirus, also a Coxsackie, but another type.
It manifests as a speckled reddish rash with painless blisters in the mouth, hands, and feet. Healing is spontaneous after about 5 days.
Human papillomavirus (HPV)
There are a hundred types of viruses HPV. We know them primarily for their responsibility in the development of genital herpes and cervical cancer. But they can also infect the oral mucosa. In this case, cauliflower-shaped warts or small nodules form on the inside of the cheeks. When they put their fingers in their mouths, children can pass warts on their hands to the lining of the mouth. HPV infection increases the risk of oral cancer.
Mononucleosis and hairy leukoplakia
The mononucleosis and hairy leukoplakia are caused by the Epstein-Barr virus (EBV).
Mononucleosis is also known as “kissing disease”. In addition to fever, fatigue, swollen glands and sore throat, small ulcers can also form in the oral cavity.
The hairy or hairy leukoplakia is common in people with weakened immune systems, such as infection with HIV or leukemia. Both sides of the tongue become covered with a whitish substance, starting with the back third of the tongue. This lesion does not cause any symptoms, but it is associated with a poorer prognosis in people infected with HIV. Hairy leukoplakia is less common with highly active antiretroviral therapy (HAART), a combination of different antivirals that are given to patients with HIV infection.
How is the diagnosis made?
Your doctor establishes the diagnosis on the basis of the physical examination. Sometimes the diagnosis needs to be confirmed by a smear of a gallbladder or a biopsy.
What can you do ?
Avoid factors that you know of may trigger a sore. Always use sunscreen with a high protection factor. Stay away from infants if you have a cold sore.
The varicella heals on its own. The child can take baths. Lukewarm water relieves the itching a bit. To dry him, dab his skin with a towel without rubbing, as the friction may tear the blisters. Small scars can form if the blisters are scratched. Various products for local use are available without a prescription. They are not proven to promote healing, however, but they cover the lesions and can soothe the itching, which will help children not to scratch.
What can your doctor do?
Sore
The cold sore heals spontaneously in 8 to 10 days. Antiviral treatment allows a little faster relief (plus or minus half a day) and a little faster healing (plus or minus 1 day). But these drugs can have side effects, sometimes serious. Due to the limited benefits and the risk of side effects, these treatments are not recommended in people with good immune defenses, even with frequent recurrences.
Chickenpox and shingles
Chickenpox resolves spontaneously. Paracetamol is only useful in case of high fever.
In people who are immunocompromised and in the presence of lesions (often around the eyes), shingles on the face is always treated with oral antiviral drugs. For pain, anti-inflammatory drugs are used.
Herpangina and foot-hand-mouth syndrome
These infections go away on their own. The treatment is symptomatic, that is to say, it is aimed only at the management of symptoms.
Human papillomavirus
Warts often go away on their own. Sometimes laser therapy, cryotherapy, or surgical resection may be indicated.
Mononucleosis and hairy leukoplakia)
For mononucleosis, symptomatic treatment is sufficient.
Hairy leukoplakia does not require treatment. The doctor will think about the possibility of a weakening of your natural defenses. If so, it will be a question of treating this condition.
Want to know more?
- Cold sores (image) – DermIS – Dermatology Information System
- Chickenpox (image) – DermIS – Dermatology Information System
- Zoster of the mouth (image) – DermIS – Dermatology Information System
- Herpangina (image) – DermIS – Dermatology Information System
- Foot-hand-mouth syndrome – Foot (image) – DermIS – Dermatology Information System
- Hand-foot-mouth syndrome – Hand (image) – DermIS – Dermatology Information System
- Hand-foot-mouth syndrome – Mouth (image) – DermIS – Dermatology Information System
- Leukoplakia (image) – DermIS – Dermatology Information System
- Paracetamol – CBIP – Belgian Center for Pharmacotherapeutic Information
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
- Antivirals – CBIP – Belgian Center for Pharmacotherapeutic Information
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