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Oriental journal of medicine and natural sciencesBog'liq 3. Yakubova,Dusmurodova Discussion
Despite the high incidence and burden of PHGS, this systematic review
underscores the limited scientific data available on its treatment. The identified
therapeutic approaches in the five included studies encompassed the use of ACV
alone or in combination, non-alcoholic chlorhexidine, viscous lidocaine, a mixture
of maalox and diphenhydramine, and aPDT. ACV, a well-tolerated antiviral
approved in 1982, is considered the first-line treatment for HSV infections,
including PHGS. It inhibits viral DNA replication without affecting non-infected
cells, and its main side effects include headache, malaise, and vomiting.
The diagnosis of PHGS is challenging due to the absence of a clear cluster
arrangement of vesicular lesions, a hallmark of herpes infections, and the rapid
resolution of blistering lesions, often resulting in unspecific erosions. The
diagnostic delay, often more than 72 hours from onset, may lead to complications
such as erythema multiforme, life-threatening encephalitis, dehydration, and
ocular involvement. The most common complication is dehydration due to
difficulties in eating and drinking, often requiring hospitalization. Erythema
multiforme, triggered by HSV-1, is a cell-mediated immune response causing
bullae, macules, and papules on the oral mucosa and skin.
ACV has demonstrated efficacy in reducing the duration of oral lesions, fever,
and other symptoms if administered within 3 days of onset. However, the studies
included in this review mainly focused on symptomatic therapies, such as honey,
non-alcoholic chlorhexidine rinses, hyaluronic acid gel, Mucosyte®, or aPDT.
These approaches aim to alleviate symptoms, especially pain, rather than
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January 2024
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