Presentation and diagnosis of recurrent oral mucocutaneous herpes

Recurrent oral mucocutaneous herpes simplex virus (HSV) infection follows reactivation of the latent HSV virus. Reactivation may be triggered by immunodeficiency, fever (eg after influenza or a chest infection), exposure to sunlight or wind, hormonal changes, or stress (emotional or physical)Better Health Channel, 2017.

Recurrent episodes are usually mild and infrequent, and are typically less severe than the initial episode of oral mucocutaneous herpes.

Lesions usually occur on the lips (herpes simplex labialis or ‘cold sores’), but can also occur on the intraoral mucosa or other areas of skin. Lesions are usually preceded by the prodromal stage (lasting several hours to days), which features pain, burning, tingling or itching. HSV reactivation may be complicated by erythema multiforme.

Diagnosis is usually clinical, and requires a thorough history and examination.