Recurrent Intraoral HSV — MFDS Part 1 MCQ

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ModerateOral PathologyRecurrent Intraoral HSVMFDS Part 1

In an immunocompetent adult, the classic distribution of recurrent intraoral herpes simplex virus infection most characteristically involves which sites?

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Correct answer: D — Hard palate and attached gingiva

Recurrent intraoral HSV classically produces localised clusters of vesicles that rapidly ulcerate on fixed, keratinised oral mucosa, particularly the hard palate and attached gingiva. This distribution distinguishes it from recurrent aphthous ulceration, which predominantly affects non-keratinised, mobile mucosa such as the buccal or labial mucosa, floor of mouth and ventral tongue. Lesions concentrated on the soft palate and tonsillar pillars are more suggestive of herpangina. Tongue-border or ventral-tongue HSV lesions can occur but are atypical and therefore are not the characteristic distribution. Recurrent HSV may have a broader distribution in immunocompromised patients, which is why the stem specifies an immunocompetent adult.

Reference: Kobayashi Y, Kusukawa J, Terasaki S, Kameyama T. Two cases of recurrent herpetic infection of the tongue. Kurume Medical Journal. 1996;43(3):237-241. https://pubmed.ncbi.nlm.nih.gov/8942144/