Hi Steve from NZ,
As the other members have already stated, this is most likely a herpetic lesion. I would like to add a few more thoughts.
Most people are exposed to and are infected by the Herpes Simplex virus as children. The initial infection that leads to "cold sores" is called Primary Herpetic Gingivostomatitis. Symptoms may include a low grade fever, swelling, blistering of the oral mucosa..both keratinized and unkeratinized, malaise, cold like symptoms and PAIN!
This is the infection that "seeds" the tissue with virus. Following the primary infection, recurrent "cold sores" will periodically appear. They usually appear in the same place each time. Severity is variable.
Recurrent infections are usually associated with some condition that alters the person's health. Exposure to sun, salt, wind, trauma, menstruation, illness, physical or emotional stress, trauma, fever, etc. all can trigger a recurrence. All of these factors can alter your immunity. However, this type of immune deficiency is not to be confused with HIV infection, although a person who is HIV infected is certainly more prone to recurrent episodes. Recurrent infections generally affect only one side or the other of the mouth or lips...the infection is asymmetrical...when the palate is involved, the viral lesions will stop at the middle of the palate.
I must differ with ScubaSarus.
Quote:
"Actaully the Herpes virus is called a latent stage virus. It hides in your DNA so antibodies can't recognize it. If antibodies attack it, the antibodies will also attack your DNA then. It lies dormant until an immune deficiency occurs and it pops out along the nerve of your lip (simplified description). It will be with you forever because its part of your genome now. Some viruses can even mutate your DNA. Viruses are not concidered living because they can't perform metabolism. They hijack a cell inject their DNA and force the cell to spontaneously assemble the DNA particles producing more virii. OK enough Micro for the night."
The Herpes virus lays dorment in the Trigeminal nerve root ganglion. When triggered, the virus multiplies and spread along affected nerve fibers...typically those affecting the lip, gums or palate. It almost exclusively affects tissues that are covered with keratin. The virus particle IS recognized by your body as foreign during an acute flare up and your body does produce antibodies to the acute infection. Antibodies to the virus particle is different than antibodies attacking infected DNA. The DNA per se does not produce an immune response. The same base pairs are found in both the virus and your cells. Over 90 percent of Americans have antibodies to the Herpes Simplex virus. Not all will have cold sores.
It is also possible to get Herpes Simplex infection of the skin and eyes. So while we usually associate the virus with cold sores, other extra-oral areas can be infected.
In my practice, I prefer to reschedule a patient with fluid filled vesicles. Not only will I make the patient more uncomfortable, it is also possible to aerosolize the fluid and contaminate the treatment room and increase the chance that I or my assistant will become infected...EVEN USING RUBBER GLOVES, MASK AND EYEWEAR!
The Herpes virus does the same thing other DNA viruses do...it incorporates its genetic information with the information from the host cells. This incorporation of DNA IS NOT a mutation although mutations can also occur. The virus DNA directs the host's cells to produce more viral particles.
Virus ARE considered to be alive
Treatment is usually topical. Pencyclovir, Acyclovir capsules or cream may be applied. Valtrex can also be used. These antiviral agents should not be used for every infection. It is best saved for more serious or painful lesions. The virus is able to become resistant.
Persons who experience frequent infections may find that taking the supplement, L-lysine daily will reduce the frequency or recurrence. Others get some relief by consuming acidophillus containing milk, tablets or yogurt. Still other persons apply ice to the lesions.
Avoiding exposure to agents that cause recurrence can also help. So using sunscreen to protect the lip from sun damage indirectly helps protect you from a viral episode. Everybody is different and that is why you seem to associate recurrent infection with diving at a certain time of year.
Prevention is the best strategy. Disinfecting rental equipment is advisable. This is a great reason to own you own.
Finally, Type I and II Herpes are visually identical. Oral type herpes can be found affecting the sexual structures and venereal herpes can affect the mouth. When infected, it is best to avoid kissing, trading eating utensils, bath towels. etc. Infective viral particles are shed from the fluid in the blisters or vesicles, and around the scab of a healing sore.
One interesting treatment is to use a red laser pointer to illuminate the lesion as early as possible. Irradiate the area so that all areas recieve 30 seconds of red light. It will often stop the infection in it's tracks...never forming vesicles or scabs! This actually works best if used during the prodromal phase...before any obvious infection is seen. When you begin to feel the tingling sensation of a recurrence, irradiate the area. If you wait until there is a scab, then the laser will do little. I know this is hard to believe but I use it in my practice and most patients report the infection goes away without even breaking the skin. The color of the laser is important. I must be a RED laser pointer.
Regards,
Laurence Stein, DDS
:doctor:
