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Gus Permana Subita
Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Diagnosis and management of recurrent herpetiform stomatitis and Behçet syndrome like recurrent aphthous stomatitis herpetiform type Wulandari, Endah Ayu Tri; Subita, Gus Permana
Padjadjaran Journal of Dentistry Vol 20, No 3 (2008): November
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (764.74 KB) | DOI: 10.24198/pjd.vol20no3.14121

Abstract

Recurrent Aphthous Stomatitis (RAS) is a common inflammatory condition of the oral mucosa. The aetiology of RAS remains unclear, yet there are several predisposing factors which could be involved in the onset of the lesion. The herpetiform type of RAS appeared to be similar to recurrent oral Herpes Simplex infection and also could be part of Behçet Syndrome. This case report discussed a patient suffering from a herpetiform type of RAS with its clinical appearance resembling recurrent oral Herpes Simplex infection and Behçet syndrome. Initial treatment was undertaken based on the empirical treatment, yet the respond was not satisfactory. Then, laboratory tests were undertaken, including complete blood count, the total population of T lymphocyte, B lymphocyte, T helper, T suppressor, NK cells, T helper/T suppressor ratio, C3, C4, IgG, IgA, and IgM. These tests showed that there were immune and hematinic deficiency condition. Nevertheless, the clinical appearance, laboratory findings and consultation did not support the diagnosis of recurrent oral Herpes Simplex infection and Behçet Syndrome, thus, enhancing the definite diagnosis of the herpetiform type of RAS with immune and hematinic deficiency as the underlying condition. Based on the definite diagnosis, treatment plan was then revised to target the underlying condition.
Oral erythema multiforme: Laboratory findings in monitoring Herpes simplex virus involvement (A case report) Raiyon, Maria Leny; Subita, Gus Permana
Padjadjaran Journal of Dentistry Vol 20, No 3 (2008): November
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2560.726 KB) | DOI: 10.24198/pjd.vol20no3.14123

Abstract

Erythema Multiforme is polymorphous recurrent eruptions on the skin and oral mucosa. This case is describing a progression of a case of Erythema Multiforme in the oral mucosa of a 33-year-old man suggesting of herpes viral involvement. In the absence of identified inducing drugs, past medical history of clinical manifestation on Herpes Simplex Viral (HSV) but positive serum antibody against HSV-1 is suggesting of Herpes Associated Erythema Multiforme. This became the basis of the patient management. Several episodes of recurrences and relapses occurred during our treatment period in oral isolated sites which were later progressed with skin eruption of bullae. The later clinical presentation challenges the on going working diagnosis. It also necessitated a skin biopsy to rule out another possibility of bullous lesion diseases. The latter blood test showed seroconverted of HSV-2 antibody accompanying previous detected HSV-1 antibody. Both biopsy and peripheral blood sera test consistent with Herpes Simplex Virus involvement. The patient is on a scheduled antiviral prophylaxis. This case showed that Herpes Associated Erythema Multiforme (HAEM) does present initially as an isolated oral lesions and a serological test could be used to monitor seroconverting of HSV.
Oral erythema multiforme: Laboratory findings in monitoring Herpes simplex virus involvement (A case report) Raiyon, Maria Leny; Subita, Gus Permana
Padjadjaran Journal of Dentistry Vol 20, No 3 (2008): November 2008
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2560.726 KB) | DOI: 10.24198/pjd.vol20no3.14123

Abstract

Erythema Multiforme is polymorphous recurrent eruptions on the skin and oral mucosa. This case is describing a progression of a case of Erythema Multiforme in the oral mucosa of a 33-year-old man suggesting of herpes viral involvement. In the absence of identified inducing drugs, past medical history of clinical manifestation on Herpes Simplex Viral (HSV) but positive serum antibody against HSV-1 is suggesting of Herpes Associated Erythema Multiforme. This became the basis of the patient management. Several episodes of recurrences and relapses occurred during our treatment period in oral isolated sites which were later progressed with skin eruption of bullae. The later clinical presentation challenges the on going working diagnosis. It also necessitated a skin biopsy to rule out another possibility of bullous lesion diseases. The latter blood test showed seroconverted of HSV-2 antibody accompanying previous detected HSV-1 antibody. Both biopsy and peripheral blood sera test consistent with Herpes Simplex Virus involvement. The patient is on a scheduled antiviral prophylaxis. This case showed that Herpes Associated Erythema Multiforme (HAEM) does present initially as an isolated oral lesions and a serological test could be used to monitor seroconverting of HSV.
Diagnosis and management of recurrent herpetiform stomatitis and Behçet syndrome like recurrent aphthous stomatitis herpetiform type Wulandari, Endah Ayu Tri; Subita, Gus Permana
Padjadjaran Journal of Dentistry Vol 20, No 3 (2008): November 2008
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (764.74 KB) | DOI: 10.24198/pjd.vol20no3.14121

Abstract

Recurrent Aphthous Stomatitis (RAS) is a common inflammatory condition of the oral mucosa. The aetiology of RAS remains unclear, yet there are several predisposing factors which could be involved in the onset of the lesion. The herpetiform type of RAS appeared to be similar to recurrent oral Herpes Simplex infection and also could be part of Behçet Syndrome. This case report discussed a patient suffering from a herpetiform type of RAS with its clinical appearance resembling recurrent oral Herpes Simplex infection and Behçet syndrome. Initial treatment was undertaken based on the empirical treatment, yet the respond was not satisfactory. Then, laboratory tests were undertaken, including complete blood count, the total population of T lymphocyte, B lymphocyte, T helper, T suppressor, NK cells, T helper/T suppressor ratio, C3, C4, IgG, IgA, and IgM. These tests showed that there were immune and hematinic deficiency condition. Nevertheless, the clinical appearance, laboratory findings and consultation did not support the diagnosis of recurrent oral Herpes Simplex infection and Behçet Syndrome, thus, enhancing the definite diagnosis of the herpetiform type of RAS with immune and hematinic deficiency as the underlying condition. Based on the definite diagnosis, treatment plan was then revised to target the underlying condition.
Co-Authors Endah Ayu Tri Wulandari Maria Leny Raiyon, Maria Leny