The Importance of Serology Examination in Diagnosis of Multiple Ulcers in Oral Cavity (Serial Cases)

摘要

Recurrent Aphthous Stomatitis (RAS) and Recurrent Intraoral Herpes (RIH) are the most common oral lesions found in dental practice. The diagnosis can be made based on patient's history and clinical examination. Due to similarity of size, shape, number, and location of these ulcers, however, it may be difficult to distinguish both of it. Serology examination of HSV-l and HSV-2 antibody is often used to establish the diagnosis. Case: Two male patients, 26 and 43 years old, came to Department of Oral Medicine with complaints of sore mouth that were not preceded by fever. From clinical examination, multiple ulcers were found in keratinized and non keratinized mucosa in sizes of 0.5 - 3 mm. Serology examination showed negative result for both anti HSV in first patient and positive result for anti HSV-1 IgG in second patient. As a result, the definitive diagnosis for first patient was Herpetiform Aphthous Stomatitis and for second one was RIH. Chlorhexidine Gluconate (12%) mouth rinse and multivitamin were prescribed for first patient and 200 mg Acyclovir tablets (5 times a day for two weeks); 100 mg Doxycycline mouth rinse and multivitamin were administered for second patient. In conclusion, Serology examination is necessary to establish diagnosis of disease with similar intraoral multiple ulcers pattern and to help the dental practitioner in developing proper management for the patient.