Herpes Simplex Infections (Non-Genital) (cont.)
Mary D. Nettleman, MD, MS, MACP
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Herpes simplex infections (nongenital cold sores) facts
- What are herpes simplex infections?
- What causes cold sores?
- What makes herpes (cold sores) recur?
- How do cold sores spread?
- What are the signs and symptoms of cold sores?
- What is primary oral herpes?
- What does recurrent herpes look like?
- How long do cold sores last?
- What are the possible complications of oral herpes (cold sores)?
- What other conditions can look like oral herpes (cold sores)?
- What is angular stomatitis?
- What are canker sores?
- How is oral herpes diagnosed?
- What is the treatment for cold sores, are there any home remedies, and what medications are used?
What other conditions can look like oral herpes (cold sores)?
What is angular stomatitis?
Angular stomatitis refers to inflammation, cracking, or irritation at the corners of the mouth. In contrast, herpes infections usually appear on the upper or lower lip margins, not in the corners. Angular stomatitis may be an initial sign of anemia or vitamin deficiency. It can also occur in people who wear dentures, whose saliva can accumulate and lead to the overgrowth of yeast.
What are canker sores?
Canker sores, or aphthous ulcers, are ulcerations that occur inside the mouth along the mucosa. They are found on the inner cheeks and lower lip as well as on the tongue, palate, and the covering of the gums. Canker sores are small, round, and painful. They are gray in color with a distinct edge. They are not contagious and are caused by stress or trauma to the area.
How is oral herpes diagnosed?
The diagnosis of herpes (cold sores) is usually based solely on the appearance of the lesions. Less commonly, viral culture or polymerase chain reaction (PCR) tests are used to help in the diagnosis of herpes infection.
Swabbing the blister in an attempt to culture the virus in the lab is only productive in the first 48 hours and before the blister has crusted over. If lesions resolve, then cultures are of no help, because there's nothing to culture. Culture results take a minimum of three to five days.
PCR testing detects herpes DNA, but it is not as readily available as culture. PCR is done on clinical specimens obtained from swabs of active lesions as described above.
Blood tests are often irrelevant, since finding antibodies to herpes just means that the body has been exposed to this virus at some point in the past. It does not determine if the current lesion is due to herpes.
If the diagnosis is in doubt, the best approach is to encourage the person to see a doctor at the first sign of a sore. That will allow the clinician to see active lesions that can be tested by culture or PCR.
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