Herpes Zoster Oral — MFDS Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMicrobiologyHerpes Zoster OralMFDS Part 1

A 68-year-old man develops burning pain over the right midface, followed by grouped vesicles on the right upper lip and multiple shallow ulcers confined to the right hard palate and maxillary attached gingiva. The lesions do not cross the midline. He had chickenpox during childhood. Which diagnosis best accounts for this presentation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Herpes zoster

The diagnosis is herpes zoster. Following childhood varicella, VZV remains latent in sensory ganglia and may reactivate along a trigeminal division. Burning prodromal pain followed by unilateral vesicles and ulcers that respect the midline is characteristic; maxillary-division involvement can affect the upper lip, hard palate and maxillary gingiva. Primary herpetic gingivostomatitis usually causes fever, diffuse bilateral oral ulceration and generalized gingivitis rather than a dermatomal distribution. Infectious mononucleosis more typically causes pharyngotonsillitis, lymphadenopathy and palatal petechiae. Herpangina predominantly affects the posterior soft palate and oropharynx, while hand, foot and mouth disease is accompanied by characteristic acral lesions.

Reference: UK Health Security Agency. Shingles (herpes zoster): the Green Book chapter 28a, section 'The disease'. Updated 19 August 2025. https://www.gov.uk/government/publications/shingles-herpes-zoster-the-green-book-chapter-28a