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2.
Medicine (Baltimore) ; 99(12): e19500, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195950

RESUMO

BACKGROUND: Lesions of herpes labialis are caused by the herpes simplex virus type 1 and cause pain and aesthetic compromise. It is characterized by the formation of small vesicles that coalesce and rupture forming extremely painful ulcers, that evolve to crusts, dry desquamations until their complete remission. Currently the treatment of these lesions is done with acyclovir. Although it diminishes the symptomatology, it causes viral resistance and does not prevent the recurrence of the lesions. It is known that antimicrobial photodynamic therapy (aPDT) has numerous advantages, among them: the reduction of the time of remission, and does not cause resistance. This protocol will determine the effectiveness of PDT in lesions of herpes labialis. MATERIALS AND METHODS: A total of 30 patients with herpes labialis in the prodromal stage of vesicles, ulcers, and crusts will be selected to participate in the study and randomized into 2 groups: G1 control and G2 experimental. After signing Research Ethics Committee and TA, patients in group G1 will undergo the standard gold treatment for herpes labialis with acyclovir and simulated PDT treatment. Patients in the experimental G2 group will be treated simulating the gold standard treatment of herpes labialis (placebo) and PDT. In all patients, saliva samples will be collected for analysis of cytokines, and will be performed exfoliative cytology in the lesions. The pain will be assessed through a pain scale and a questionnaire of quality of life related to oral health (OHIP-14) will be given to them. Patients will continue to be followed up after 7 days, 1 month, 3 months, and 6 months; if there is a recurrence of the lesion, they will contact the researchers.Clinical registration: clinicaltrials.gov - NCT04037475. Registered on July 2019.


Assuntos
Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Herpes Labial/terapia , Fotoquimioterapia/métodos , Aciclovir/efeitos adversos , Adulto , Antivirais/efeitos adversos , Feminino , Herpes Labial/patologia , Herpes Labial/virologia , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 1/efeitos da radiação , Humanos , Masculino , Dor/etiologia , Estudos Prospectivos , Qualidade de Vida , Recidiva , Úlcera/patologia , Escala Visual Analógica , Adulto Jovem
3.
Eur Neurol ; 83(1): 105-110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32222716

RESUMO

OBJECTIVE: The aim of the work was to study the origin of the idea that herpes labialis (HL) in patients with pneumonia and meningitis was believed to be of prognostic importance. BACKGROUND: HL is caused by a primary infection or reactivation of herpes simplex type I. In the past, it has been related to pneumonia and meningitis; moreover, HL was believed to be of prognostic importance. METHODS: A selection of 19th- and 20th-century textbooks and referred articles was consulted. The relation between meningitis and herpes, type of meningitis, and attributed diagnostic and prognostic importance were studied. In addition, the HL-pneumonia association was studied. RESULTS: The Strasbourg physician Charles-Polydore Forget was the first to describe the HL-meningitis association in 1843. Tourdes (1843), Drasche (1859), and Salomon (1864) attributed a favorable prognostic importance to the HL-meningitis relation. In a comprehensive monograph (1866), August Hirsch, although confirming the association, denied the prognostic importance through critical analysis of the data. Few authors attributed a diagnostic importance to the occurrence of HL, suggesting meningococcal meningitis. CONCLUSIONS: The HL-meningitis relation, but not the prognostic importance, has been mentioned in most neurological textbooks since then. In contrast to meningitis, in which a prognostic attribution of HL was only a short-lived 19th-century idea, the favorable prognostic importance of HL in pneumonia continued to be described until the 1950s. A possible protective effect of herpesviruses has been found in recent years. One could speculate that the disappearance of the prognostic HL-pneumonia relation could be related to the introduction of antibiotics in the late 1940s.


Assuntos
Herpes Labial/história , Meningites Bacterianas/história , Neurologia/história , Adulto , História do Século XIX , História do Século XX , Humanos , Pneumonia/história , Prognóstico
4.
J Cosmet Dermatol ; 19(1): 135-136, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31050128

RESUMO

Recurrence of orofacial herpes simplex infection is a well-known potential complication of chemical peeling procedures. Risk of reactivation is believed to correlate with depth of peel, leading to the recommendation that all patients with history of primary orofacial herpes simplex infection or recurrent herpes labialis receive prophylactic antivirals prior to and after undergoing medium and deep peels. The following is a case of herpes labialis following a very superficial peeling procedure in an otherwise healthy 30-year-old male after primary infection as a neonate with no history of herpes simplex recurrence in the intervening 30 years. This case highlights the importance of history-taking and consideration of prophylactic antivirals in peels of all depths in patients with any history of primary infection, regardless of length of disease free period.


Assuntos
Abrasão Química/efeitos adversos , Herpes Labial/diagnóstico , Herpesvirus Humano 1/fisiologia , Ativação Viral , Adulto , Antivirais/uso terapêutico , Face , Herpes Labial/tratamento farmacológico , Herpes Labial/etiologia , Herpesvirus Humano 1/isolamento & purificação , Humanos , Ácido Láctico/administração & dosagem , Masculino , Recidiva , Valaciclovir/uso terapêutico
5.
Oral Dis ; 25(8): 1850-1865, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31733122

RESUMO

The natural history of oral herpes simplex virus type 1 (HSV-1) infection in the immunocompetent host is complex and rich in controversial phenomena, namely the role of unapparent transmission in primary infection acquisition, the high frequency of asymptomatic primary and recurrent infections, the lack of immunogenicity of HSV-1 internalized in the soma (cell body) of the sensory neurons of the trigeminal ganglion, the lytic activity of HSV-1 in the soma of neurons that is inhibited in the sensory neurons of the trigeminal ganglion and often uncontrolled in the other neurons, the role of keratin in promoting the development of recurrence episodes in immunocompetent hosts, the virus-host Nash equilibrium, the paradoxical HSV-1-seronegative individuals who shed HSV-1 through saliva, the limited efficacy of anti-HSV vaccines, and why the oral route of infection is the least likely to produce severe complications. The natural history of oral HSV-1 infection is also a history of symbiosis between humans and virus that may switch from mutualism to parasitism and vice versa. This balance is typical of microorganisms that are highly coevolved with humans, and its knowledge is essential to oral healthcare providers to perform adequate diagnosis and provide proper individual-based HSV-1 infection therapy.


Assuntos
Herpes Labial , Herpes Simples , Herpesvirus Humano 1 , Estomatite Herpética , Humanos , Gânglio Trigeminal
6.
Pediatr Dermatol ; 36(6): 808-814, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31497896

RESUMO

Recurrent herpes labialis (RHL) is an incredibly common condition, though the medical literature evaluating pediatric aspects is limited. This paper assesses prevalence and therapeutic studies of pediatric RHL as well as disease complications. A comprehensive literature search of English-language citations based on PubMed queries of selected terms was performed, with exclusion if methodology was not discussed, or if studies had 10 or fewer patients. RHL prevalence in pediatrics has been assessed by measures of point and periodic prevalence, though methodologic limitations may under- or over-estimate the true prevalence of RHL. Studies have been conducted to evaluate therapeutic safety, tolerability, and efficacy of antivirals in the pediatric population. Pediatric RHL point prevalence ranges from 0.72% to 5.2% depending on the population study and the methodologies used. Pediatric RHL carries a significant public health burden and is often implicated in patients with eczema herpeticum, erythema multiforme, reactive infectious mucositis eruptions, and hypersensitivity reactions. There are few studies that evaluate the rates of occurrence of these sequelae associated with pediatric RHL.


Assuntos
Antivirais/uso terapêutico , Herpes Labial/complicações , Herpes Labial/tratamento farmacológico , Criança , Herpes Labial/epidemiologia , Humanos , Prevalência , Recidiva
7.
Viral Immunol ; 32(6): 258-262, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31145049

RESUMO

Recurrent infections of herpes simplex virus in the orolabial area are known as recurrent herpes labialis (RHL). Vitamin D has been shown to have an important immunomodulatory role and to be associated with several infectious diseases. This hospital-based case-control study aimed at investigating the association between vitamin D and RHL by comparing vitamin D levels in individuals with and without RHL. Individuals who presented to the dermatology clinic at a state hospital due to RHL (n = 50) and matching control group of healthy volunteers (n = 51) were studied. Their vitamin D levels were measured, stratified based on clinical guidelines, and compared. The average serum vitamin D (25-hydroxyvitamin D) levels were 23.8 ± 15.5 and 42.0 ± 26.3 nM in the patient and control groups, with significant differences between their average serum vitamin D levels and vitamin D status. The studied population had serious vitamin D deficiency regardless of having RHL, with vitamin D levels below the adequate limits in more than 96% of the population. Most importantly, the study established a significant association between low serum vitamin D levels and the presence of RHL. Further interventional and pathophysiological studies should clarify the nature and mechanism of the relationship.


Assuntos
Herpes Labial/sangue , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Vitamina D/sangue , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Herpes Labial/imunologia , Herpesvirus Humano 1 , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Turquia , Adulto Jovem
8.
BMJ Open ; 9(5): e026201, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31092654

RESUMO

OBJECTIVE: To compare New Zealand medical grade kanuka honey with topical aciclovir for the treatment of herpes simplex labialis. DESIGN: Prospective parallel randomised controlled open-label superiority trial. SETTING: 76 community pharmacies across New Zealand between 10 September 2015 and 13 December 2017. PARTICIPANTS: 952 adults randomised within the first 72 hours of a herpes simplex labialis episode. INTERVENTIONS: Random assignment 1:1 to either 5% aciclovir cream or medical grade kanuka honey (90%)/glycerine (10%) cream, both applied five times daily. OUTCOME MEASURES: The primary outcome was time from randomisation to return to normal skin (stage 7). Secondary outcomes included time from randomisation to stage 4 (open wound), time from stage 4 to 7, maximal pain, time to pain resolution and treatment acceptability. RESULTS: Primary outcome variable: Kaplan-Meier-based estimates (95% CI) for the median time in days for return to normal skin were 8 (8 to 9) days for aciclovir and 9 (8 to 9) for honey; HR (95% CI) 1.06 (0.92 to 1.22), p=0.56. There were no statistically significant differences between treatments for all secondary outcome variables. No related serious adverse events were reported. CONCLUSION: There was no evidence of a difference in efficacy between topical medical grade kanuka honey and 5% aciclovir in the pharmacy-based treatment of herpes simplex labialis. TRIAL REGISTRATION NUMBER: ACTRN12615000648527;Post-results.


Assuntos
Aciclovir/administração & dosagem , Antivirais/administração & dosagem , Herpes Labial/tratamento farmacológico , Mel , Adulto , Feminino , Humanos , Kunzea , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Farmácias/estatística & dados numéricos , Estudos Prospectivos , Cicatrização/efeitos dos fármacos
9.
Immun Inflamm Dis ; 7(1): 22-40, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30756512

RESUMO

INTRODUCTION: Differences in immune characteristics, including immune gene expression by peripheral blood mononuclear cells (PBMCs), correlating with herpes labialis and good or poor immune control of herpes simplex virus type 1 (HSV-1), and how these characteristics change after dosing with squaric acid dibutyl ester (SADBE), were investigated. METHODS: PBMCs were collected from persons positive for IgG against HSV-1 and having frequent, infrequent, or no herpes labialis outbreaks. The PBMCs were tested for proliferation against HSV-1 and a fungal antigen (Candida) and immune gene expression in the presence of HSV-1 and Candida. On day 1 after blood collection the subjects with frequent outbreaks were dosed topically on the arm once with SADBE, and their PBMCs were collected and tested 8 weeks later. RESULTS: Those with good immune control of their HSV-1 infection (fewer outbreaks) differ from those with poorer immune control in these ways: (1) Greater PBMC proliferation in vitro to HSV-1, HSV-1-infected cell extracts, and Candida considered together (P < 0.01). (2) Higher expression of IFNG and five other immune-related genes (P < 0.05 for each) and lower expression of IL5 and two other immune-related genes (P < 0.05 for each) in PBMCs in vitro stimulated with HSV-1 virus. The subjects with frequent outbreaks were treated once with SADBE, and 56 days later the PBMCs of these subjects differed from PBMCs from the same subjects taken on day 1 before treatment in exactly the same ways listed above as differences between those with good and poor immune control of HSV-1, and at the same levels of significance. CONCLUSIONS: Higher IFNG and lower IL5 expression by PBMCs in the presence of HSV-1 correlate with fewer herpes labialis outbreaks, and a single topical dose of SADBE to the arm of subjects with frequent herpes labialis episodes improves immune response to HSV-1.


Assuntos
Antivirais/uso terapêutico , Candida/imunologia , Ciclobutanos/uso terapêutico , Herpes Labial/imunologia , Herpes Simples/imunologia , Herpesvirus Humano 1/fisiologia , Leucócitos Mononucleares/fisiologia , Adolescente , Adulto , Feminino , Regulação da Expressão Gênica , Humanos , Interferon gama/metabolismo , Interleucina-5/metabolismo , Masculino , Pessoa de Meia-Idade , Recidiva , Adulto Jovem
10.
World Neurosurg ; 127: e16-e21, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30771541

RESUMO

BACKGROUND: Herpes simplex virus (HSV) reactivation after surgery for trigeminal neuralgia has long been recognized. Only a few studies to date have focused on this complication, and its actual incidence remains unknown. The aim of this study was to investigate the incidence of postoperative herpes labialis (HL) in a cohort of patients treated with either percutaneous balloon compression or microvascular decompression to identify potentially significant differences between different treatments. METHODS: A total of 92 patients who were operated on for TN with microvascular decompression (group A) or percutaneous balloon compression (group B) in the period 2010-2017 were retrospectively evaluated. The 2 subgroups of patients were compared according to history of previous HL and incidence of postoperative HL. RESULTS: The final cohort comprised 56 male and 36 female patients. Average age was 58.50 years; 30 male patients belonged to group A and 26 male patients belonged to group B. Lifetime incidence of episodes of HL before surgery in 18/58 patients in group A (31.0%) and 12/34 patients in group B (35.3%), with no statistically significant difference among subgroups. Postoperatively, 1/56 patients in group A (1.7%) experienced HL compared 5/34 patients in group B (14.7%), with a strongly statistically significant difference between the 2 subgroups. CONCLUSIONS: In our clinical experience, herpes simplex virus reactivation after surgery for trigeminal neuralgia is not so rare and is still not completely understood. Postoperative herpes simplex virus reactivation could be due to a direct mechanical injury on gasserian ganglion neurons, which is more common after percutaneous balloon compression.


Assuntos
Herpes Simples/etiologia , Complicações Pós-Operatórias/virologia , Simplexvirus/fisiologia , Neuralgia do Trigêmeo/cirurgia , Ativação Viral , Feminino , Herpes Labial/etiologia , Herpes Labial/virologia , Herpes Simples/virologia , Humanos , Complicações Intraoperatórias/virologia , Masculino , Cirurgia de Descompressão Microvascular , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Gânglio Trigeminal/lesões , Gânglio Trigeminal/fisiopatologia , Gânglio Trigeminal/virologia
11.
Dermatol Ther ; 32(3): e12847, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30693632

RESUMO

Erythema multiforme (EM) is an immune-mediated reaction characterized by target lesions and with possible mucosal involvement. Its most frequent cause is HSV, with HSV-1 more common than -2. It is usually self-limited but it can show recurrences. We report a peculiar case of recurrent herpes-associated erythema multiforme (HAEM) in a 35-year-old man. The patient was affected by both herpes labialis and genitalis, but the typical target lesions were only associated with recurrent herpes labialis. Here, we hypothesize about the pathogenic differences between HSV-1 and HSV-2, and discuss the therapeutic management of HAEM.


Assuntos
Eritema Multiforme/virologia , Herpes Genital/complicações , Herpes Labial/complicações , Adulto , Eritema Multiforme/terapia , Herpes Genital/terapia , Herpes Labial/terapia , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 2/isolamento & purificação , Humanos , Masculino , Recidiva
13.
J Dermatolog Treat ; 30(2): 179-182, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29804485

RESUMO

BACKGROUND: Research results on the efficacy of sunblock sticks in avoiding or reducing Herpes labialis (HL) recurrences are contradictory and has shown mixed results, with some protection reported under experimental conditions that could not be replicated under natural conditions. OBJECTIVE: The purpose of the present work was to carry out an in vivo test on the effectiveness of a protective lip product in preventing recurrent HL in natural conditions during summer. METHODS: An exploratory randomized crossover study was performed on 20 adult volunteers who served as their own controls during the analysis. The study was conducted between May and July 2017 around the summer solstice. During the two-month period, volunteers had to perform normal daily activities and also needed to go to the beach in Sardinia; thirty subjects applying SPF 30 protection and 30 without protection. RESULTS: In individuals with stick protection, the number of HL attacks was significantly reduced. Based on association between different parameters, which emerged from the medical history and the post-test questionnaire, it was found that male individuals over 44 y of age and with Fitzpatrick skin type 2 were the most exposed to recurrence. CONCLUSION: HL recurrence rate can be reduced by using sunblock stick in summer.


Assuntos
Herpes Labial/prevenção & controle , Protetores Solares/farmacologia , Adulto , Estudos Cross-Over , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva
17.
G Ital Dermatol Venereol ; 154(5): 529-532, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28181784

RESUMO

BACKGROUND: Recently, Herpes simplex virus (HSV)-1 seroprevalence declined among adolescents, rendering young people lacking HSV-1 antibodies more susceptible to genital HSV-1 acquisition, if sexually exposed. The aim of the present study was to identify the possible risk factors for the development of HSV-1 related Herpes genitalis (HG). METHODS: From January 2012 to December 2015, patients with HG attending three Sexually Transmitted Infections Units in Northern Italy were recruited. A genital swab on the lesions for the search of HSV-1/2 DNA through real time polymerase chain reaction (PCR) and a serum sample for HSV-1/2 specific serology were performed. Moreover, patients were asked whether they had personal history of herpes labialis (HL). Patients with PCR proved HSV-1 HG were included as cases; asymptomatic subjects attending STI Units for a blood check were recruited as controls and were checked for HSV-1/2 serology. RESULTS: The study included 141 cases and 70 controls. Specific HSV-1 antibodies were found in 34.7% of the cases and 67% of the controls. History of recurrent herpes labialis (RHL) was found in 4% of the cases and 31% of the controls. The occurrence of RHL in HSV-1 seropositive patients resulted lower in the case group compared to the control group. CONCLUSIONS: We can speculate about a protective role for RHL against the clinical appearance of HSV-1 HG. The clinical usefulness of our study involved especially the counselling in serodiscordant couples. The presence of HSV-1 antibodies in asymptomatic sexual partners does appear protective for HG manifestation only in presence of RHL history.


Assuntos
Anticorpos Antivirais/análise , Herpes Genital/diagnóstico , Herpes Labial/diagnóstico , Doenças Sexualmente Transmissíveis/diagnóstico , Adolescente , Adulto , DNA Viral/análise , Feminino , Herpes Genital/epidemiologia , Herpes Labial/epidemiologia , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 2/isolamento & purificação , Humanos , Itália , Masculino , Recidiva , Fatores de Risco , Estudos Soroepidemiológicos , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/virologia , Adulto Jovem
18.
J Infect Dis ; 219(7): 1058-1066, 2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30383234

RESUMO

BACKGROUND: Orolabial herpes simplex virus type 1 (HSV-1) infection has a wide spectrum of severity in immunocompetent persons. To study the role of viral genotype and host immunity, we characterized oral HSV-1 shedding rates and host cellular response, and genotyped viral strains, in monozygotic (MZ) and dizygotic (DZ) twins. METHODS: A total of 29 MZ and 22 DZ HSV-1-seropositive twin pairs were evaluated for oral HSV-1 shedding for 60 days. HSV-1 strains from twins were genotyped as identical or different. CD4+ T-cell responses to HSV-1 proteins were studied. RESULTS: The median per person oral HSV shedding rate was 9% of days that a swab was obtained (mean, 10.2% of days). A positive correlation between shedding rates was observed within all twin pairs, and in the MZ and DZ twins. In twin subsets with sufficient HSV-1 DNA to genotype, 15 had the same strain and 14 had different strains. Viral shedding rates were correlated for those with the same but not different strains. The median number of HSV-1 open reading frames recognized per person was 16. The agreement in the CD4+ T-cell response to specific HSV-1 open reading frames was greater between MZ twins than between unrelated persons (P = .002). CONCLUSION: Viral strain characteristics likely contribute to oral HSV-1 shedding rates.


Assuntos
Herpes Labial/imunologia , Herpes Labial/virologia , Herpesvirus Humano 1/genética , Eliminação de Partículas Virais/genética , Adulto , Idoso , Linfócitos T CD4-Positivos/imunologia , Feminino , Genótipo , Herpes Labial/classificação , Herpesvirus Humano 1/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Boca/virologia , Fases de Leitura Aberta/genética , Fases de Leitura Aberta/imunologia , Filogenia , Gêmeos Dizigóticos , Gêmeos Monozigóticos , Adulto Jovem
19.
Wien Med Wochenschr ; 169(7-8): 193-201, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30406509

RESUMO

A lip cream with special propolis extract GH 2002 at a concentration of 0.5% (199 patients) was tested against aciclovir 5% (198 patients) in the treatment of episodes of herpes labialis under double-blind conditions. Upon inclusion, all patients were in the vesicular phase. Application was five times daily of approximately 0.2 g of cream to the entire upper and lower lip. The primary parameter was the difference in time between groups to complete encrustation or epithelization of the lesions. Secondary endpoints were the course of typical herpes symptoms (pain, burning and itching, tension and swelling), the global assessment of efficacy and the safety of application. The predefined clinical situation was reached after a (median) 3 days with propolis and 4 days with aciclovir (p < 0.0001). Significant differences in favor of propolis were also found for all secondary parameters. No allergic reactions, local irritations or other adverse events occurred.


Assuntos
Antivirais , Apiterapia/métodos , Herpes Labial , Própole , Aciclovir/uso terapêutico , Adulto , Antivirais/uso terapêutico , Método Duplo-Cego , Feminino , Herpes Labial/tratamento farmacológico , Humanos , Lábio , Masculino , Própole/uso terapêutico , Recidiva , Resultado do Tratamento
20.
Emerg Med Clin North Am ; 37(1): 55-68, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30454780

RESUMO

Soft tissue disorders of the mouth encompass a wide expanse of pathophysiology. This article focuses on the identification, etiology, management, and complications of common infectious processes (candidiasis, dental caries, and herpes labialis), inflammatory lesions (sialolithiasis, oral lichen planus, and aphthous ulcer), and benign entities (bony tori and mucocele).


Assuntos
Doenças da Boca/diagnóstico , Candidíase Bucal/diagnóstico , Candidíase Bucal/tratamento farmacológico , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Emergências , Herpes Labial/diagnóstico , Herpes Labial/tratamento farmacológico , Humanos , Leucoplasia Oral/diagnóstico , Leucoplasia Oral/terapia , Líquen Plano Bucal/diagnóstico , Líquen Plano Bucal/terapia , Doenças da Boca/terapia , Mucocele/diagnóstico , Mucocele/terapia , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/terapia , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/terapia
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