• Page | 28 Volume 1 Issue 1 | January 2024
  • Oriental journal of medicine and natural sciences




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    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 


    Page | 28 
    Volume 1 Issue 1
     | 
    January 2024 

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    Oriental journal of medicine and natural sciences

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