(BMJ)—A 79-yo man w/ squamous lung CA who was on palliative care presented w/ painful tongue lesions that were assoc w/ a reduced sense of taste and contributed to anorexia and weight loss. He had no response to initial tx for oral candidiasis. Tongue exam: white, circular, plaquelike lesions. What is the dx?
Oral florid papillomatosis
Stomatitis nicotina
Herpes simplex
Hairy leukoplakia
Lichen planus
You are correct. Oral swabs were positive for herpes simplex virus type 1, w/ a raised viral load. This pt was treated w/ oral valacyclovir. His lesions and assoc sx of pain and anorexia resolved after 6 days.

BMJ 2017;358:j3193