HIV: MOUTH PROBLEMS-SORES, BLISTERS, OR ULCERS ON THE LIPS OR MOUTH: APHTHOUS ULCERS
Sores or blisters on the lips or mouth or in the throat are usually caused by one of two conditions. One is an infection by the virus herpes simplex; the other is a condition called aphthous ulcers, whose cause is unknown.
Aphthous ulcers are open sores that may look like herpes simplex sores, occurring in the mouth, usually on the inside surface of the cheeks, on the gums, and on the tongue. Aphthous ulcers are usually very painful, especially when touched or when food or liquids pass over them. The pain can severely limit a person’s desire to eat. Like thrush and herpes, the ulcers may extend to the esophagus and impair the ability to swallow. The ulcers can occur in people with or without HIV infection, but they are more common and severe in those with HIV infection.
Aphthous ulcers are often mistaken for herpes simplex infection, which they resemble. But laboratory tests of aphthous ulcers do not show any specific microbe, and the treatment for herpes simplex infection is unsuccessful in treating aphthous ulcers. The cause of these ulcers is not known. Aphthous ulcers are not transmitted to others. Aphthous ulcers may recur over a period of many years.
The usual treatment is to rinse the mouth with viscous lidocaine (2 percent concentration) or the combination of viscous lidocaine and benadryl taken by mouth. Both of these drugs are available without prescription. Severe ulcers may require prescription drugs such as
corticosteroids given either as a pill or as a gel that can be applied to the surface of the ulcer. Aphthous ulcers in the esophagus are usually treated with corticosteroids and usually respond well.
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