Severe crusting of the lips along with pain and fever and lymphadenopathy.
Herpetic Gingivostomatitis

Children may acquire HSV-1 asymptomatically or they may develop herpetic gingivostomatitis--primary initial infection of the lips, mouth, and gingiva by herpes simplex virus, usually HSV-1. See also herpes labialis and herpes simplex.


In herpetic gingivostomatitis, there is vesiculation, crusting, and erosions most common of the lips and perioral skin. Erythema and erosions may occur in the mouth, e.g., buccal mucosa, tongue, and gingiva. Fever and lymphadenopathy may occur. Recurrent outbreaks may develop later (see herpes labialis).


Acyclovir 200 mg 5/day should be prescribed. Soaks BID to reduce crusting is helpful. Petrolatum locally will decrease crusting, pain, and speed healing. For painful oral lesions, viscous lidocaine or compounded mouthwashes may be employed.

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