title: Oral ulcers in children under chemotherapy: clinical characteristics and their relation with Herpes Simplex Virus type 1 and Candida albicans.
abstract: OBJECTIVE
  The objective of this study was to determine the clinical characteristics of oral ulcers in pediatric oncology patients undergoing chemotherapy and their relation with the presence of Herpes Simplex Virus (HSV) type 1 and Candida albicans.
  
  
  METHODS
  The sample consisted of 20 ulcerative lesions from 15 children treated with chemotherapy in the Pediatric Service of the Regional Hospital of Concepción, Chile. Two calibrated clinicians performed clinical diagnosis of the ulcers and registered general data from the patients (age, general diagnosis, absolute neutrophil count, and number of days after chemotherapy) and clinical characteristic of the ulcers: number, size, location, presence or absence of pain and inflammatory halo, edge characteristics, and exudate type. Additional to clinical diagnosis, culture for Candida albicans (C) and polymerase chain reaction (PCR) for Herpes Simplex Virus type 1 was performed.
  
  
  RESULTS
  Ten ulcers occurred in patients with acute lymphoblastic leukemia, five in patients with acute myeloblastic leukemia and five in patients with other neoplastic diseases. Eight ulcers were HSV (+) / C (-), 6 HSV (-) / C (-), 4 HSV (+) / C (+) and 2 HSV (-) / C (+). Preferential location was the hard palate. Most lesions were multiple, painful, with inflammatory halo, irregular edges and fibrinous exudate. The average size was 6,5 millimeters, and the mean number of days after chemotherapy was 7.5 days.
  
  
  CONCLUSIONS
  Oral ulcers in children with oncological diseases did not present a specific clinical pattern. They were strongly associated with HSV.
authors.affiliation: Departamento de Diagnóstico y Patología Oral, Universidad de Concepción, Chile. esepulve@udec.cl
authors.forename: Ester
authors.initials: E
authors.lastname: Sepúlveda
authors.forename: Ursula
authors.initials: U
authors.lastname: Brethauer
authors.forename: Jaime
authors.initials: J
authors.lastname: Rojas
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fernández
authors.forename: Patricia
authors.initials: P
authors.lastname: Le Fort
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002176:Candida albicans / Q000472:pathogenicity; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D018259:Herpesvirus 1, Human / Q000472:pathogenicity*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007938:Leukemia / Q000188:drug therapy*; D008297:Male; D019226:Oral Ulcer / Q000276:immunology / Q000382:microbiology / Q000473:pathology / Q000821:virology*; D013283:Stomatitis, Herpetic / Q000209:etiology* / Q000276:immunology
chemical_list: D000970:Antineoplastic Agents; D004279:DNA, Viral