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Author(s): Dr Nihal Peeris, General Practitioner (2023). Reviewing dermatologist: Dr Ian Coulson
Edited by the DermNet content department
This man has had recurring sore lesions always on the left side of his palate.
There are clustered erosions on the left side of the palate.
(They started with a prodrome of soreness and then vesicles developed, which have now eroded.)
The recurrent nature of the eruption occurring in the same area of the palate and the clustering of the vesicles and later erosions is typical of herpes simplex virus (HSV) infection, usually HSV type 1.
By taking viral swabs — this can be subjected to either viral culture or PCR.
Aciclovir 200 mg five times a day for 5 days and chlorhexidine mouthwash twice a day for 5 days are reasonable options for an acute attack. Repetitive frequent recurrences may need long term suppressive aciclovir.