Oral Lesion

1. LESI AKIBAT VIRUS
DIAGNOSIS & GAMBAR LESI DESKRIPSI LESI
(GAMBARAN
KLINIS)
TREATMENT
PLANNING
Erythema Multiforme
- Etiologi:
Minor (less severe) form
usually triggered by herpes
simplex virus
Major form (Stevens-
Johnson syndrome/Toxic
Epidermal Necrolysis) often
triggered by drugs,
Hypersensitivity reaction to
infectious agents, drugs, or
idiopathic
- Sudden onset; painful,
wide-spread; crusted ulcers
on vermilion of lips; usually
self-limited; young adults;
may also have target or iris
lesions of skin; may be
recurrent, especially
in spring and fall; some
cases become chronic;
uncommon.
-Diagnosis Banding:
Primary HSV infections,
aphthous ulcers, pemphigus
vulgaris, mucous membrane
pemphigoid, paraneoplastic
pemphigus, and erosive
lichen planus.
- Obat Kumur
- Kortikosteroid
Topical
- Antifungal
- Acyclovir 400-
600mg, bila
ditrtiggert oleh HSV
- Suportif: irrigation,
adequate fluid
intake, and use of
antipyretics, may
provide patients with
substantial benefit
HERPES SIMPLEX INFECTIONS
Primary Herpetic Gingivostomatitis
-Etiologi: Herpes simplex
virus type 1 (occasionally
type 2)
- PRIMARY HERPETIC
GINGIVOSTOMATITIS
Occurs most commonly in
children younger than
10 years and second most
commonly in young adults;
pain, fever, malaise,
irritability, Headache,
lymphadenopathy, and
- Suplemen Lysine
3000-9000mg/hari,
- antiviral drugs
systemic (acyclovir
400mg 3x sehari,
amciclovir,
penciclovir,
valacyclovir
1000mg 2x sehari)
- Topical Acyclovir
5x sehari

2. Reccurent Herpes Simplex
Herpes Simplex Labialis
pharyngitis; Marginal gingiva
initially become fiery red and
edematous. The interdental
papillae swell and bleed after
trauma because of capillary
ragility and increased
permeability. Widespread
inflammation of the marginal
and attached gingiva
develops, and small clusters
of vesicles rapidly erupt
throughout the mouth.
Vesikel dapat pecah, forming
yellowish ulcers that are
individually circumscrbibed
by a red halo. Lesi yang
berdekatan dpat bergabung
membentuk suatu ulcer yang
besar, oada mukosa bukal,
labial, gingiva, palatum, lidah
dan bibir.
Bisa terdapat erosi dangkal
pada area perianal dan krusta
hemorragik sekitar bibir.
-Diagnosis Banding:
streptococcal pharyngitis,
erythema multiforme, and
acute necrotizing ulcerative
gingivitis (ANUG, or
Vincent’s infection)
-INFEKSI REKUREN
HERPES SIMPLEX
Recurrences are often
precipitated by sunlight,
heat, stress, trauma (dental
procedures), or
immunosuppresssion.
Recurrences on the vermilion
border of the lip (recurrent
herpes labialis) are clinically
more apparent than intraoral
recurrences (recurrent
herpetic stomatitis). pain
and tenderness/lunak/lembek
of afected tissues. Prodromal
neurogenic symptoms, such
as tingling/geli,
throbbing/berdenyut, and

3. burning, biasanya mengawali
erupsi dari lesi. Gejala
lainnya sama spt Herpetitc
Gingivostomatitis.
-Diagnosis Banding:
Pemphigus Vulgaris, Erosive
Lichen Planus, Linear
Immunoglobulin (Ig)A
Disease, Contact Allergy,
Discoid Lupus
Erythematosus,
Epidermolysis Bullosa
Acquisita
Herpangina / Apthous Pharyngitis / Vesicular
Pharyngitis
-Etiologi: Disebabkan oleh
virus coxsackie tipe A (types
A1-6, A8, A10, A22) dan
dapat juga di sebabkan oleh
coxsakie tipe B(B3),
Enterovirus, Echovirus,
Adenovirus. Terjadi bisa juga
karena factor genetic
(defisiensi glucose-6-
phosphate
dehydrogenase,polymorphism
pada limfosit T). Defisiensi
mikronutrien Antara lain
selenium dan vitamn E.
-Consist of a small number
light-gray papillary vesicles
that
rupture to form
discrete/terpisah,
shallow/dangkal ulcers. The
ulcers have an erythematous
border and are limited to the
posterior oral cavity
(tonsillar pillars, palate,
uvula). Ulserasi diameter
rata-rata 2 sampai 4 mm dan
di kelilingi oleh Eritema.
Diffuse/menyebar pharyngeal
erythema, dysphagia, and
sore throat are common
features, as are fever, malaise,
headache, lymphadenitis,
abdominal pain, and
vomiting.
-Treatment is palliative
(obat utk meredekan rasa
sakit tanpa berurusan
dengan penyebab kondisi
tsb), and spontaneous
healing occurs within 7 to
10 days (Self-Limiting
Disease)
-Infeksi virus coxsakie
merupakan self-limiting
(sangat sedikit mengalami
komplikasi)dan terapi
segera untuk mengontrol
demam dan nyeri pada
mulut,terapi suportif dan
membatasi kontak dengan
orang lain untuk mencegah
penyebaran infeksi
-Agent antiviral yang efektif
untuk coxsakie tidak
tersedia
-Terapi suportif meliputi
keseimbangan cairan
(hidrasi), control demam
menggunakan
acetaminophen/paracetamol,
obat kumur allopurinol juga
dikatakan dapat membantu
penyembuhan.

4. -Diagosis Banding:
Hand, Foot and Mouth
Disease (HFMD), Infeksi
Primer HSV, Chickenpox
Chikenpox
-Etiologi: Varicella and
herpes zoster are caused by
the same virus, Varicella-
zoster virus (VZV)—a type
of human herpesvirus.
Herpes Zoster (Shingles) is
the recurrent neurodermal
infection.
-
Herpes Zoster (Shingles)
Hand, Foot and Mouth Disease (HFMD)