Unusual Oral Presentations of Herpes Simplex Virus‐1: A Series of Eight Cases and Literature Review
Bibliographic record
Abstract
AIMS: The aim of this study is to characterize the clinical and microscopic features of recurrent oral/labial HSV-1 infection with unusual clinical presentations. METHODS: A literature review and retrospective case series of patients with recurrent oral/labial HSV-1 with unusual presentations were conducted. Data were collected from medical records, and all cases were confirmed by histopathology and immunohistochemistry. RESULTS: Eight patients (five males, 62.5%; three females, 37.5%) with a mean age of 61.8 years presented with unusual HSV-1 manifestations, including solitary lesions, white plaque-like appearance, non-keratinized site involvement, or prolonged duration. Lesions involved the tongue border (n = 4, 50%), anterior ventral tongue, hard palate, posterior ridge crest, and lower lip (n = 1, 12.5% each). Presented as well-demarcated solitary ulcers (n = 6, 75%), solitary papule (n = 1, 12.5%), and whitish plaque-like lesions (n = 1, 12.5%). Only two patients were immunosuppressed. All cases responded successfully to management, including pharmacotherapy, surgical excision, or photobiomodulation. Unusual clinical presentations of oral/labial HSV-1 infection are scarcely reported in the literature. CONCLUSION: Unusual HSV-1 manifestations can occur in immunocompetent individuals; however, exclusion of undiagnosed immunosuppression remains necessary. A definitive diagnosis relies on careful histopathological evaluation of ulcer edges, which is crucial for guiding appropriate treatment. Further documentation of similar cases is essential to reinforce that these unusual presentations can indeed affect immunocompetent patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".