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The high frequency of herpes infection in children determines the need to search for new diagnostic markers, evaluate treatment efficacy and predict relapse of the disease. The purpose of the work is to assess the possibility of using biochemical analysis of oral fluid to assess the effectiveness of treatment of children with acute herpetic stomatitis. In the oral fluid and blood plasma of 28 children of patients with acute herpetic stomatitis in the dynamics of the disease, the content of total protein, proteins of the acute phase of inflammation, as well as the concentrations of calcium, magnesium, copper and zinc was determined spectrophotometrically. Oral fluid and blood plasma of 45 practically healthy children were used as a control. In acute herpetic stomatitis, the content of C-reactive protein, orosomucoid, α1-antitrypsin, ceruloplasmin, prealbumin and microalbumin, as well as magnesium, calcium and zinc, increases in the oral fluid of children, but the level of total protein and transferrin decreases. In this blood plasma, the level of ceruloplasmin, orosomucoid, C-reactive protein, α1-antitrypsin is higher, and zinc is lower than in healthy children. The copper content in the oral fluid and blood plasma of children increases with moderate herpetic stomatitis, and significantly decreases with severe herpetic stomatitis. The degree of changes in the content of the proteins of acute phase of inflammation and indicators of mineral metabolism of the oral fluid and blood plasma of children with a herpetic infection of the oral cavity correlates with the severity of the disease. Highly significant correlations were revealed when comparing the concentrations of proteins of the acute phase of inflammation, electrolytes between the oral fluid and the blood plasma of children with acute herpetic stomatitis. After treatment of children with acute herpetic stomatitis, the content of minerals and proteins of the acute phase of inflammation in the oral fluid returned to normal only with a mild disease severity. A method has been developed for evaluating the effectiveness of treatment of children with acute herpetic stomatitis by determining the content of minerals in the oral fluid. The ratio of copper to calcium in the oral fluid of children more than 45 should be considered an indicator of effective treatment of children with herpetic stomatitis., Competing Interests: The authors declare no conflict of interest.

Purpose: Herpes simplex gingivostomatitis (HSGS) in children is a common painful infectious disease. This study aims to examine the combined efficacy of honey with acyclovir suspension compared to acyclovir alone for treating HSGS in young children., Material and Methods: This Randomized double blind placebo controlled study was conducted from June 2015 to September 2017 in a tertiary referral hospital. One hundred children aged 2-8 years with HSGS were randomly classified into 2 groups; study group: treated with honey plus oral acyclovir and control group: treated with oral acyclovir alone. Severity of oral lesions, Fever, eating and drinking ability, pain scores and need for analgesics were compared between 2 groups on day 3, 5 and 7 after starting treatment., Results: Children receiving honey plus acyclovir (i.e. study group) had significantly earlier disappearance of herpetic oral lesions; median 3 days vs. 6 days in control group (P = 0.022), drooling; 2 days vs. 4 days (P = 0.030) and eating difficulty; 3 days vs. 8 days (P = 0.001). Study group also had significantly lower pain scores, better eating and drinking ability and significantly less need for analgesics at 3 time-points of assessment. Fever disappeared in both groups with no statistically significant difference., Conclusions: The combined use of honey with oral acyclovir can produce favorable outcome than acyclovir alone in children with Primary herpetic gingivostomatitis., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Research ebjective was to study assessment of quality organization of work treatment recurrent herpetic stomatitis in patients of industrial enterprises from employees.172 patients on the industrial enterprises from 25 to 54 year were treated recurrent herpetic stomatitis. Clinical efficiency of immunomodulator quality therapy of recurrent herpetic stomatitis for assessment organization of work in employees industrial is proved by estimation of oral cavity local immunity (SIgA, lisozyme). After treatment of recurrent herpetic stomatitis in employees signifie and (p<0,005) inerease of lisozyme and SIgA. The obtaiquality of treatment of recurrent herpetic stomatitis et employees of industrial enterprises.

Mesenchymal stem cells (MSCs) have potent immunomodulatory functions and are a promising therapy for immune-mediated inflammatory disorders. We previously demonstrated the efficacy of fresh, autologous, adipose-derived MSCs (ASCs) to treat feline chronic gingivostomatitis (FCGS), a chronic oral mucosal inflammatory disease similar to human oral lichen planus. Here, we investigate the use of fresh allogeneic ASCs for treatment of FCGS in seven cats. Radiolabeled ASCs were also tracked systemically. Each cat received two intravenous injections of 20 million ASCs, 1 month apart. Oral inflammation, blood lymphocyte subsets, anti-fetal bovine serum antibody levels, ASC crossmatching and serum proteins and cytokine concentrations were determined. Four of the 7 cats (57%) responded to treatment [complete clinical remission (n = 2) or substantial clinical improvement (n = 2)]. Three cats were nonresponders. Prior to therapy, most cats had increased circulating CD8+ T cells, decreased CD8 lo cells, and a decreased CD4/CD8 ratio, however clinical resolution was not associated with normalization of these parameters. Nonresponders showed more severe systemic inflammation (neutrophilia, hyperglobulinemia and increased interferon gamma and tumor necrosis factor alpha concentration) prior to ASC therapy. Clinical remission took up to 20 months and no clinical relapse has occurred. A higher fraction of radiolabeled ASCs were identified in the oral cavity of FCGS affected cats than the control cat. The administration of fresh, allogenic ASCs appeared to have lower clinical efficacy with a delayed response as compared to the fresh, autologous ASCs. In addition, the mechanism(s) of action for autologous and allogenic ASCs may differ in this model of oral inflammation. Stem Cells Translational Medicine 2017;6:1710-1722., (© 2017 The Authors Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press.)

Herpes labialis remains a common worldwide affliction. Recent advances in understanding the basic pathogenesis have led to new therapeutic intervention, both on-label and off-label. Aside from reducing the duration and symptomatology of acute outbreaks, another goal of treatment is to decrease the frequency of future episodes. Oral and topical acyclovir and its analogues are the mainstay of both chronic suppressive and episodic therapy. A new muco-adhesive formulation of acyclovir provides a decrease in outbreaks, probably due to a diminution of herpesvirus load in all reservoir sites. Acyclovir-resistant strains are rare in immunocompetent hosts; parenteral foscarnet and cidofovir are administered in this situation. Parenteral acyclovir is the drug of choice for eczema herpeticum, which may begin as herpes labialis in an atopic dermatitis patient. Thermotherapy may be beneficial, and a certified device to deliver heat is available outside the United States.

J Drugs Dermatol. 2017;16(3 Suppl):s49-53.

Transplacental transmission of HSV infection is rare, typically associated with Herpes Simplex Virus 2 (HSV-2) and often reported in term infants, whereas only a few cases of preterm infants with Herpes Simplex Virus 1 (HSV-1) infection are found in the literature. We report the case of a transplacental HSV-1 infection in preterm twins born at 27 weeks gestation. At 23 weeks gestation the mother had experienced primary gingivostomatitis and "flu-like" symptoms, which healed without specific treatment. At birth both infants presented disseminated ulcerated skin lesions at the head, trunk and extremities. Soon after birth, the infants required mechanical ventilation and showed multiple organ involvement. On the basis of the mother's positive HSV-1 serology, treatment was established before the Tzanck test, serological findings and polymerase chain reaction of the skin and blood had confirmed the neonatal infection. In spite of the early diagnosis within hours after birth and immediate treatment, the extensive skin involvement associated with rapidly progressing multiorgan failure resulted in death of both infants within 3 days. Although a primary HSV-1 infection during pregnancy is extremely rare, gingivostomatitis with general symptoms can lead to transplacental infection and should therefore be taken seriously. Prompt recognition and treatment in the mother are paramount and might be life-saving for the infants., (© Georg Thieme Verlag KG Stuttgart · New York.)

Oral herpes virus infections (OHVIs) are among the most common mucosal disorders encountered by oral health care providers. These infections can affect individuals at any age, from infants to the elderly, and may cause significant pain and dysfunction. Immunosuppressed patients may be at increased risk for serious and potential life-threatening complications caused by OHVIs. Clinicians may have difficulty in diagnosing these infections because they can mimic other conditions of the oral mucosa. This article provides oral health care providers with clinically relevant information regarding etiopathogenesis, diagnosis, and management of OHVIs., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Emergency physicians should be comfortable treating most dental and related infections. In this article, we outline recommended techniques to perform a dental examination, explore common pathologies, recommend pain and antibiotic management strategies and review common pitfalls. How to avoid overprescribing opioid analgesics is discussed in depth, along with recent studies to support this strategy., (Published by Elsevier Inc.)

Objectives: The objectives of this study were to determine the number of hospital emergency department (ED) visits with a diagnosis of herpetic gingivostomatitis (HGS) for 2007 in the United States and to identify the possible comorbid conditions associated with HGS., Study Design: The Nationwide Emergency Department Sample for 2007 was used in this study. Patients who visited the ED with a diagnosis of HGS were selected. Estimates were projected to the national levels using the discharge weights. Presence of comorbid conditions in these patients was also analyzed., Results: A total of 23,124 patients had ED visits and received the diagnosis of HGS. Most of the patients were young females and those belonging to the lower socioeconomic strata. All patients with HGS also presented with comorbid conditions., Conclusions: Physicians should be trained to diagnose, manage, and refer common dental emergencies. In the long term, improving access to dental care for these patients is crucial to managing this problem., (Copyright © 2012 Elsevier Inc. All rights reserved.)

The most common infections of the oral mucosa are those caused by Candida albicans and herpes simplex virus (HSV). Candidosis occurs as pseudomembraneous, erythematous and hyperplastic types with varying symptoms from no to a burning sensation. Treatment most importantly includes elimination of any predisposing factors such as smoking, sub-optimal denture hygiene and hyposalivation. A primary HSV infection results in a life-long latent infection recurring in some infected persons either intraorally or on the lip. If treatment is indicated, topical or systemic aciclovir and related drugs can be used.

The exact pathophysiology and curative treatment of many common dermatologic conditions remain unclear. Often conventional treatments are only partially effective, leading patients to look for alternative treatments. Rosacea may be helped by azelaic acid. Seborrheic dermatitis may be helped by tea tree oil. Chronic urticaria may be helped by a focused dietary history and elimination of food additives and salicylates. Although various alternative treatments have been touted as useful in herpes simplex, few have proved efficacious., (Copyright 2010 Elsevier Inc. All rights reserved.)

Objectives: Recapitulation of our knowledge dealing with diagnosis and therapy of oral mucosal diseases caused by HSV., Material and Methods: Analysis of a sample of 135 patients coming from Department of Dentistry, Faculty of Medicine in Hradec Králové within 11 years. Statistical evaluation of the data and related associations (clinical diagnosis, age, gender, general health status, treatment mode) were realized by ANOVA analysis, t-test, and Fisher's exact test., Results: A total sample of 135 individuals (81 women and 54 men) consisted of 49 individuals with primary herpetic gingivostomatitis (37 %) and recurrences with clinical signs of herpetic stomatitis in 68 patients (50 %) and labial herpes simplex in 18 patients (13 %) aged from 1 to 90 years, mean age 40.4 year, with maximal occurrence in the 3rd and 7th decades. The mean age of individuals with herpetic gingivostomatitis was significantly lower (p = 0.0001). The occurrence of herpetic stomatitis was associated with severe concomitant diseases (p = 0,0001). Topical treatment was applied in 73 individuals (54 %), combined mode in 58 individuals (43 %), only systemic therapy in 4 individuals (3 %). In most of individuals with herpetic gingivostomatitis only topical treatment was used (80 %, in most of herpetic recurrences combined therapy was applied (62 %)., Conclusions: The age of individuals with primary infection and herpetic recurrences was significantly different. Herpetic stomatitis occurred often as an opportunistic viral infection in seriously ill and older patients. Antiseptics with antiviral properties and their combinations with systemic administration of antiviral drugs proved successfully in the treatment.

In the study with participation of 96 children of 1-7 years age with recurrent herpetic stomatitis and allergic diseases therapeutic efficacy of Polioxidonium was investigated. Polioxidonium was used in combination with traditional methods and with He-Ne-laser irradiation. Local oral cavity immunity, indexes of cellular immunity (in the reaction of lymphocytes blast-transformation with phytohemagglutinin), indexes of humoral immunity (IgG and IgE) were studied, complement C(3)-component was determined. Polioxidonium in combination with traditional methods and with laser therapy for recurrent herpetic stomatitis treatment in children with allergic diseases influenced favourably upon clinical course of allergic diseases, let achieve stable remission, increased efficacy of their treatment, promoted immunological status and shorten the terms of medical rehabilitation.

Objective: To review the treatment of primary herpetic gingivostomatitis at a children's hospital., Methods: A review of charts from 1999 to 2003., Results: Forty-eight cases were identified. They ranged in age from 8 months to 12 years, with a median age of 2 years 7 months. All children were treated with fluids and analgesics; 11 children were treated with fluids and analgesics exclusively. Thirty-five children were treated with a mixture of Maalox and diphenhydramine, 8 with acyclovir, and 7 with viscous lidocaine; 11 children were treated with 2 or more of these regimens. Both the Maalox and diphenhydramine mixture and the viscous lidocaine were administered as swish and swallow, swish and spit, or by application with a swab as frequently as every hour or as infrequently as every 8 hours., Conclusions: Topical therapy with Maalox and diphenhydramine or viscous lidocaine was administered to 73% and 15% of the patients, respectively, whereas acyclovir was administered to only 17%. Dosing and administration of topical agents in the treatment of primary herpetic gingivostomatitis in preschoolers were problematic. Acyclovir was not being used as often as it could have been.

This series provides an overview of current thinking in the more relevant areas of oral medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach--as it largely relates to the presenting complaint--was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail.

The purpose of the study was the estimation of complex treatment effectiveness of chronic recurrent herpetic stomatitis using portable laser device "Beurer" (Germany). Fifty patients 17 till 55 years of age were investigated. Among them 28 were women and 22 were men. They were divided into two groups. All patients were treated by standard algorithm according to the severity of the disease. In the patients from the second group laser therapy by means of SL-30, 15-30 min per day was administered. After the completion of the course of treatment positive therapeutic effect has been achieved in all patients from the second group. Disappearance of the subjective symptoms and the initiation of the reparative-regenerative processes has occurred much faster in this group which gave us an opportunity to reduce the number of sessions by 5-6 in comparison with the first group. Thus, it was shown that the use of apparatus SL-30 in complex treatment of the chronic recurrent herpetic stomatitis increases the efficiency of the treatment.

The infections due to herpes viruses are widely spread, people being every day at high risk of contamination starting early age. The characteristic of the herpes virus infection consists of a symptom less evolution following the prime infection. As for any other herpetic infection, episodes infection exacerbation is due to some determining factors. Clinical symptom in herpes virus infection varies according to the virus type, age of the patient and site. Oral signs and symptoms are numerous, extremely intense and often, difficult to diagnose. Progressing in so many ways and being diagnosed and treated by so many medical specialties it is difficult to evaluate the actual number of cases. Consequently it is mandatory to train dentists in order to be able to accurately diagnose and treat the herpetic infection and to prevent nosocomial cross infections in dental office.

A case of noma with involvement of other parts of the body from extension and spread of cancrum lesion in the oral cavity and primary herpetic stomatitis in a two-year-old male patient is reported. The possible routes of infection to other parts of the body are discussed. It is expected that this case report will stimulate the awareness of health practitioners to this unusual presentation of cancrum oris.

Oral ulceration is a common complaint of patients attending out-patient clinics. The aim of this review is to provide the gastroenterologist with a differential diagnosis of oral ulceration, and a practical guide for the management of recurrent aphthous stomatitis, including topical and systemic therapy. The association of recurrent aphthous stomatitis with Behçet's disease and other systemic disorders, including coeliac disease, is discussed. Recent evidence concerning the immunopathogenesis of Behçet's disease is reviewed, including renewed interest in the role of Streptococcus sanguis and possible infectious triggering of an inappropriate immunoinflammatory response, resulting in tissue damage. The efficacy and limitations of conventional treatment for this mutisystem disorder are outlined together with the potential role of novel biological agents, such as anti-tumour necrosis factor-alpha therapy. Oral ulceration, as a manifestation of inflammatory bowel disease and a complication of drug therapy, is described. Guidance is given concerning indications for referral of patients with oral ulceration to an oral physician/surgeon for further investigations, including biopsy if appropriate.

The most common pathologic alterations seen by dentists are oral mucosal ulcerations, particularly those related to the herpes simplex virus and those produced by the autoimmune phenomenon known as recurrent aphthous stomatitis. Because the general frequency and clinical similarity of these conditions often make it difficult to distinguish one from the other, therapeutic intervention may be inappropriate. An improved understanding of the virologic and local immunologic alterations within the oral mucosa has led to a better understanding of these conditions and to the development of improved treatment strategies within the general practice setting for a significant number of otherwise healthy patients.

Oral infections caused by herpes simplex type 1 are widespread, even among otherwise healthy people. While most of these herpetic infections are asymptomatic, young children are at risk for developing extensive oropharyngeal vesicular eruptions when first infected with the virus. This initial outbreak is known as primary herpetic gingivostomatitis. Although a self-limiting disease, this oral infection can cause significant mouth discomfort, fever, lymphadenopathy, and difficulty with eating and drinking. Symptoms may persist for 2 weeks. Diagnosis can be made clinically and confirmed by laboratory tests. Some young children require hospitalization for management of dehydration and pain control. Pediatric nurses working in both primary and acute care settings will encounter this oral infection in young children. Antiviral therapy with acyclovir has proven effective in the management of primary herpetic gingivostomatitis. Providing supportive care and educating parents about transmission of the virus are important aspects of nursing care.

Radiotherapy for head and neck tumours is a viable treatment modality. However, a wide range of potentially debilitating dental complications may accompany the treatment. In Part 2 of this article, prevention and management strategies available to the dental practitioner to stave off the dental side effects of radiotherapy are explored and particular attention is given to the management of xerostomia and radiation caries.

The American Academy of Periodontology has developed the following parameter on the treatment of acute periodontal diseases. Patients should be informed about the disease process, therapeutic alternatives, potential complications, expected results, and their responsibility in treatment. Consequences of no treatment should be explained. Failure to treat acute periodontal diseases appropriately can result in progressive loss of periodontal supporting tissues, an adverse change in prognosis, and could result in tooth loss. Given this information, patients should then be able to make informed decisions regarding their periodontal therapy.

The mouth is the most common site of primary and recurrent herpes simplex virus (HSV) infection. The clinical appearance of recurrent intraoral HSV infection is similar to that of recurrent aphthous stomatitis. Reactivation of HSV occurs in bone marrow transplantation and is more frequent in patients conditioned with total body irradiation than in patients conditioned without total body irradiation. Although the effect of oral acyclovir to prevent recurrent herpes labialis is not confirmed, recurrent HSV lesions can be treated with the ointment formulation successfully. A therapeutic approach using replication-competent HSV may be useful in the treatment of tumors of epithelial origin, such as carcinoma of the upper aerodigestive tract.

Herpetic and aphthous ulcers can be easily separated from each other on a clinical basis. Most patients who suffer from recurrent oral ulcers, suffer from one of the three forms of aphthous stomatitis that can be effectively treated. Unfortunately, the dental and medical professions are uninformed about recurrent oral ulcer etiology and proper therapies. The result is that large numbers of patients are repeatedly told there is no adequate treatment or control for their condition when in most cases that is not true. We should not permit that trend to continue. Our patients deserve better treatment from a more informed profession.

Twenty-seven patients with chronic herpetic stomatitis were treated using routine protocols including traditional autohemotherapy (controls, n = 12) and magnetic autohemotherapy (main group, n = 15) developed by the authors. Local therapy was identical in both groups and corresponded to the disease stage. Treatment with magnetic autohemotherapy proved to be highly effective: it prolonged the remission and reduced the incidence and duration of exacerbations. Cytological findings indicate that such an exposure activated the processes of regeneration of the buccal and labial mucosal epithelium. A trend to normalization of some parameters of cellular and humoral immunity was observed.

The oral mucous membranes may manifest a vast array of disease states. Pediatric patients with oral diseases pose unique challenges in diagnosis and management. An overview of mucositis and xerostomia are presented along with helpful diagnostic features to differentiate recurrent aphthous stomatitis from recurrent herpes simplex infection.

Immunoglobulin with a high titer of antiherpetic antibodies (1:640 to 1:1280) was used for the treatment of children with acute and recurrent herpetic stomatitis. The agent was injected intramuscularly, 2 to 4 injections, depending on the disease severity. The results evidence a favorable effect of the drug on the clinical and immunologic parameters of patients suffering from the acute condition and permit a conclusion that this immunoglobulin prevented the development of recurrent forms in the children with the acute disease.

Clinical efficacies of ointments containing alpha- and gamma-interferon and characterized by antiviral activity (2.0 x 10(4) IU) were studied. Antiviral effect of these ointments used in the treatment of 168 children suffering from herpetic stomatitis was assessed from the clinical and immunologic viewpoints. Measurements of secretory IgG carried out over the course of therapy evidenced positive changes in local immunity.

Human fibroblast interferon (HuIFN-beta) was topically administered to 20 premalignant lesions histopathologically showing epithelial dysplasia such as leukoplakia and lichen planus which arose in the oral mucosa. HuIFN-beta was prepared in the water-soluble gel form containing 2% carboxymethylcellulose, 45% glycelin, 0.1 M citrate buffer (pH 4.5) and 0.2% SDS as stabilizing agents. This preparation was found to be effective for herpetic gingivostomatitis and zostal lesions arising along the intercostal nerve. Thus, the HuIFN-beta preparation (10(4) to 5 X 10(3) IU) was applied to the oral mucosal lesion for 1 h twice a week. The lesion with topical administration of HuIFN-beta was covered tightly with the mucosal bandage which was coated with carboxymethylcellulose, glycelin and CaCl2 on vinyl acetate matrix. The 14 oral lesions with erosion or ulcer formation accompanied by severe pain by touch, had complete remission after approximately 10 successive applications of this preparation. Although subjective symptoms such as irritation pain in the other 6 patients with severe hyperkeratotic lesion subsided, white coatings and streaks could not be completely removed by this therapy. No other side-effects excluding slight pain and reddish swelling which occurred intermittently during HuIFN-beta administration were observed.