Recurrent Herpes Labialis — ORE Part 1 MCQ

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EasyOral MedicineRecurrent Herpes LabialisORE Part 1

A patient reports several previous episodes of a painful blistering lesion affecting the lower lip. On this occasion, tingling developed at the site before a unilateral cluster of vesicles appeared on the vermilion border. What is the most likely diagnosis?

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Correct answer: E — Recurrent herpes labialis

Explanation lettering: C = shown as A · E = shown as C · A = shown as E

A is correct. Recurrent herpes labialis (a cold sore) typically causes a prodrome of tingling, burning or itching followed by painful fluid-filled vesicles on or around the lip. Repeated, localised episodes support viral reactivation rather than a primary infection. Primary herpetic gingivostomatitis usually produces widespread oral ulceration and painful gingivitis, often with systemic symptoms, rather than an isolated recurrent lip lesion. Impetigo may crust and affect the face but does not characteristically have a recurrent local prodrome of tingling and grouped vesicles. Erythema multiforme has target lesions, commonly on the skin, with more extensive mucosal involvement when oral. Angular cheilitis affects the oral commissures and presents with fissuring or soreness, not vesicles on the vermilion border.

Reference: NHS, “Cold sores”, Symptoms of a cold sore, current page accessed July 2026: https://www.nhs.uk/conditions/cold-sores/