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, 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.
What other conditions can look like oral herpes (cold sores)?
There are many conditions that can be confused with herpes, including abrasions, razor burns, pimples, angular stomatitis, and canker sores (aphthous ulcers).
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.
Genital herpes, a viral infection by the herpes simplex virus (HSV), is transmitted during sexual contact with the mucous-covered linings of the mouth, vagina, or the genital skin. A typical outbreak begins with an itching or tingling sensation followed by redness of the skin and blister formation. The blisters and ulcers that form when the blisters break are painful to the touch, and last from 7 days to 2 weeks. Though there is no cure for herpes, there are ways to treat outbreaks.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Canker sore is a small ulcer crater in the lining of the mouth. Canker sores are one of the most
common problems that occur in the mouth. Canker sores typically last for
10-14 days and they heal without leaving a scar.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Erythema nodosum is a skin inflammation that results in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. Erythema nodosum can resolve on its own in 3 to 6 weeks, leaving a bruised area. Treatments include anti-inflammatory medications and cortisone by mouth or injection.
Before treating a cold, the flu, or allergies with over-the-counter (OTC) medications, it's important to know what's causing the symptoms, which symptoms one wishes to relieve, and the active ingredients in the OTC product. Taking products that only contain the medications needed for relieving your symptoms prevents ingestion of unnecessary medications and reduces the chances of side effects.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Scar formation is a natural part of the healing process after injury. The depth and size of the wound incision and the location of the injury impact the scar's characteristics, but your age, heredity and even sex or ethnicity will affect how your skin reacts.
A ganglion is a fluid-filled cyst that forms from the joint or tendon lining. Ganglia are most frequently found in the ankles and wrists and are usually painless. A ganglion often resolves on its own. Aspiration of the ganglion fluid or surgery may be necessary.
The HPV virus (genital warts) in men can cause health problems. Genital warts are confined primarily to the moist skin of the genitals or around the anus. Genital warts are caused by the human papillomaviruses (HPVs), which are transmitted through sexual contact.
Herpes of the Eye is developed by the herpes simplex 1 virus that usually lives around the nerve fibers in humans. Symptoms of herpes of the eye include pain in and around only one eye, redness rash or sores on the eyelids, redness of the eye, and swelling and cloudiness of the cornea.
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