Oral manifestations of chickenpox
Chickenpox is an acute infectious disease of viral origin caused by the varicella-zoster virus (VZV), also known as human herpesvirus type 3.
It primarily affects children between the ages of 5 and 9 and adolescents. After the primary infection, the virus can remain latent in the sensory and even motor nerves, reactivating during periods of immunosuppression in the form of shingles, both in childhood and adulthood.
1. Initial Clinical Presentation
The disease usually begins with systemic symptoms such as:
- Fever
- Headache
- General malaise
- Pulmonary congestion
- Sore throat
Subsequently, the most characteristic sign appears: a generalized skin rash, which begins as erythematous macules and progresses to papules, vesicles, and finally pustules.
2. Oral Manifestations
Oral lesions are common, especially in patients with more severe forms of the disease:
- Small vesicles (3–4 mm), located on the tongue, inner cheeks, hard palate, gums, and posterior pillars.
- These vesicles rupture rapidly (within about 24 hours), forming shallow ulcers that are yellowish-white with an erythematous halo, generally mildly painful or painless.
- There is a possible association between chickenpox and incisor-molar hypomineralization syndrome if the infection occurs during tooth calcification, especially in first permanent molars.
3. Differential Diagnosis
Patients may seek medical attention due to the presence of these oral lesions, either because of a suspected diagnosis or because of discomfort. In such cases, the following should be considered:
- Minor recurrent aphthous stomatitis, if there are single lesions.
- Primary herpes infection, in the presence of multiple lesions.
4. Treatment
The therapeutic approach is symptomatic and palliative:
- In most cases, no specific treatment is required.
- Analgesics may be prescribed if the ulcers cause discomfort.
5. Conclusion
Oral manifestations of chickenpox are a clinically significant aspect that
