Difference between Aphthous Ulcers and Herpes

Aphthous ulcer in the back of the mouth.

Apthous Ulcers vs Herpes

An Ulcer is break in the continuity of any tissue, skin or others. Apthous ulcers (canker sores) are painful, non-infectious, non-contagious ulcers seen inside the mouth whereas Herpes is an infectious, contagious disease caused by the herpes simplex virus (HSV). HSV-type 1 causes oral herpes which is the infection of the face and mouth. HSV-type 2 causes genital herpes which affects the genitals, buttocks and anal region. The herpes virus can also infect the brain and eyes.

Apthous ulcers are seen inside the mouth i.e. on the tongue, insides of the lips or the throat whereas in oral herpes, we observe water-filled blisters usually on the lips and around the mouth.

Apthous ulcers are produced due to various factors which include injury to the oral mucosa by dentures, broken tooth or harsh brushing techniques. Stress and anxiety are also known to trigger ulcer formation. A deficiency of iron, vitamin B12 or folic acid is known to cause ulcers too. Certain drugs like Ibuprofen can also trigger ulcers. Apthous ulcers are seen in Crohn’s disease (chronic inflammatory disease of the intestines). They are also seen in cases of HIV infections. Oral Herpes spreads from person to person through close contact. Genital herpes is sexually transmitted. Herpes is usually seen in patients whose immunity is lowered e.g. in cases of HIV infection and in cancers. Stress, illness, fever and sun exposure also trigger a dormant herpes infection.

Apthous ulcers are small, painful ulcers usually yellow or white in colour with a red border. Patient complains of a burning/stinging sensation in the mouth, before the appearance of the ulcer. If ulcers are present on the tongue, they cause difficulty in chewing food. If ulcers are present in the throat, they cause pain while swallowing. In herpes, there is formation of fluid filled blisters around the mouth or on the genitals. Blisters eventually then break open, ooze fluid and form a crust. There is burning before the appearance of the blister. This is followed by itching and pain. Patients may also develop fever and enlargement of the lymph nodes in the neck.

In cases of apthous ulcers, tests like complete blood count, vitamin B12, and folic acid levels are done. In herpes, a blood test for detecting antibodies of HSV is done. Also, the sample is cultured for the presence of virus.

A patient with apthous ulcers is advised to avoid spicy food, acidic beverages, citrus fruits etc. Supplements of vitamin B12, folic acid and iron are given to the patient. Oral Tetracycline mouth wash and steroidal lozenges are advised to the patient. Local application of antibiotics, anti inflammatory, pain relief medicines is advised. The aim of treatment is to reduce pain, prevent infection and help healing. In herpes, anti-viral medicines are given. A patient with genital herpes is advised to use a condom to prevent transmission of the virus during a sexual act. Oral and genital hygiene should be maintained by the patient.

Summary

Apthous ulcers are painful, non-contagious ulcers that commonly occur inside the mouth whereas Herpes is an infectious, contagious disease caused by herpes simplex virus. In oral herpes, blisters develop on the outer lip and around the mouth.
Apthous ulcers are caused due to injury by dentures, broken teeth; vitamin B12, folic acid deficiency; stress; certain drugs etc whereas herpes is commonly seen in patients with low immunity; in fever etc.
Diagnosis is confirmed by complete blood count. In severe cases, biopsy of the ulcer is required to detect the cause. Treatment of apthous ulcers include local applications of antibiotics, pain relief ointments, mouth wash and steroidal lozenges. Treatment of herpes includes anti-viral medicines.

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