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Basic HIV Primary Care.

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Oral ManifestationsQuestion 6/10

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A 30-year-old cisgender man with HIV presents for evaluation of a painful ulcer in his mouth. On examination, there is a shallow ulcerated lesion on the upper lip (Figure 1). He does not have lesions on any other parts of his body. One week prior, he was seen with similar symptoms and specimens obtained for herpes simplex virus (HSV) polymerase chain reaction (PCR) and culture were negative. Serologic syphilis testing (IgG antibody) is negative. Testing for mpox is negative. He has not had sores like this previously. In addition, he has not had any sexual contact for approximately 4 months.

Which one of the following would you recommend for the initial treatment of this patient’s oral lesions?

Shallow ulcerated lesion on upper lip with a surrounding ring of erythema.
Figure 1. Lip Ulcer
Shallow ulcerated lesion on upper lip with a surrounding ring of erythema.
Source: photograph from David H. Spach, MD
Large and deep ulcerated lesion on left alveolar mucosal region with fibrinous material at lower portion of ulcer. The alveolar process refers to the ridge of bone that contains the tooth sockets. 
Figure 2. Alveolar Mucosal Lesion.
Large and deep ulcerated lesion on left alveolar mucosal region with fibrinous material at lower portion of ulcer. The alveolar process refers to the ridge of bone that contains the tooth sockets. 
Photograph courtesy of Mark Nichols, DDS, Dental Director, South Central AETC
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Question Last Updated
September 30th, 2023

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