Parent Dominique
Hôpital Erasme, clinique de pathologie des muqueuses, université libre de Bruxelles, service de dermatologie, 808, route de Lennik, Bruxelles, Belgique.
Presse Med. 2016 Feb;45(2):196-214. doi: 10.1016/j.lpm.2015.10.018. Epub 2016 Feb 4.
Exclude herpes infection in the presence of acute oral ulcers of unknown origin, particularly in patients in poor general condition. Remember that asymptomatic HSV-1 shedding in saliva may result in an oral-genital transmission. Perform an anogenital examination and a screening for other sexually transmitted diseases when oral warts are diagnosed. Search for immunosuppression and monitor the patient (screening for a potential associated carcinoma) when there is rapid growth of oral warts. Consider all the clinical signs (systemic, skin, other mucosa, immunity...) when a patient has an enanthem or oral ulcerations. Ask for a HIV test when an oral Kaposi's sarcoma, a hairy leukoplakia or major aphthae are diagnosed.
对于病因不明的急性口腔溃疡患者，尤其是全身状况较差的患者，应排除疱疹感染。记住，唾液中无症状的HSV-1脱落可能导致口-生殖器传播。诊断口腔疣时，应进行肛门生殖器检查并筛查其他性传播疾病。当口腔疣迅速生长时，应寻找免疫抑制情况并监测患者（筛查潜在的相关癌症）。当患者出现黏膜疹或口腔溃疡时，应考虑所有临床体征（全身、皮肤、其他黏膜、免疫……）。诊断口腔卡波西肉瘤、毛状白斑或重型阿弗他溃疡时，应进行HIV检测。
