Differential diagnosis: is it herpes or aphthous?

Recurrent aphthous stomatitis (RAS) and recurrent intraoral herpes (RIH) are the two most commonly presenting oral lesions in the dental setting. It is critical that the oral health professional be able to accurately discriminate between these disorders. To facilitate the differential diagnosis between RAS and RIH, important components of assessment are discussed. These include: prodromal signs and symptoms, lesion location, and appearance of the initial and mature lesion. The comparative etiology, prevalence, pathogenesis, and treatment considerations for these lesions are presented. A familial case report is provided.