CHARACTERISTIC FEATURES

€¢ Outbreaks may begin with a prodromal phase of up to 24 hours before any visible signs appear, during which the area on or around the lips begins to tingle, burn or itch.
€¢ Erythema then develops, followed by the formation of painful and irritating fluid-filled blisters on the lips and skin around the mouth, which break down into shallow, weeping ulcers within 1€“3 days.
€¢ The ulcers dry and form crusts, which are shed, and the area heals within a further 2 weeks.
€¢ The total length of an episode is usually 10€“20 days.
€¢ Initial outbreaks in children typically manifest as gingivostomatitis, with lesions all over the inside of the mouth and symptoms of systemic infection. Primary infection in adolescents manifests as pharyngitis, with lesions in the throat and symptoms similar to glandular fever.