Introduction : Herpes Labialis is the most common form of orofacial herpes, beginning with a feeling of vesicle formation at the vermilion margin of the lips and the surrounding area within 24 hours and then rupture, superficial erosion occurs which is then covered with crusts. Herpes labialis occurs in 50-75% of individuals exposed to HSV-1 infection in the oral cavity and often has a recurrence followed by prodromal symptoms. Reactivation can occur due to triggers in the form of decreased immune conditions due to weather changes, fever, sun exposure, emotional stress, trauma, menstruation, systemic diseases, allergies, and immunosuppression. Case: 22 years old female with a complaint of a wound on the angular lip, initially the patient had a fever for 2 days then a fluid-filled blister appeared which then rupture. Case Treatment: The diagnosis is made using anamnesis, clinical and supporting examination. CBC and Antybody Titer HSV-1 show value under normal for eosinophil and reactive for IgG HSV-1 established. Patient take medicine topical antiinflammation 3 time a day and multivitamins 1 time a day. Discussion: HSV-1 infektion is latent and can reaktivation. Under Stress Condition can caused a reduced circulating population of immune cells such as IL-6, TNFα, Lymphocites B, NK cell, dan Monocytes which HSV-1 Reactivation. Conclucion: Management in case can be successful if the clinician understand HSV-1 Infection Manifestation and added Suporting Examination. In Addition, cooperation from the patien is needed to manage stress so that the disease no more recurrence.

Introduction: Allergic stomatitisis ahypersensitivity reaction caused by allergens, such as drugs, food, and dental materials. Manifestation allergic reaction to food in oral cavity can be recurrent ulcer. Purpose: This case report pupose to report management allergic stomatitis in Stress condition.Case: female was a 44-year-old with complaintmany stomatitis in oral cavity. Patients say often since ± 6 years ago without knowing the cause. Stomatitis often moving location but also in the same site. On intra oral examination found ulcer multiple, variant size, irregular shape, paintfull.Management: the patient performed examination of total IgE with a result of 642.98 (normal<150), skin prick test in patients results positive on dust house, dog hair, cotton, beef, cow's milk, chicken egg yolk, shrimp, milkfish, pindang, chocolate, and peanuts.Patients given aloe vera extract oral rinse at the first visit, then after skin prick test was given methylprednisolone, hepaprotector caplet, multivitamin B-Complex plus Zinc. Patients are also given education and instruction to avoid a food become allergic. Conclusion: Allergic Stomatitis diagnosis requires a complete history and supportive examination. In this case, the treatment requires good cooperation between the patient and the dentist so that treatment can be done thoroughly.

Herpes-associated erythema multiforme (HAEM) is an acute inflammatory mucocutaneous disease which is characterized by ulcerative lesion on oral mucous membrane with or without skin involvements. The etiology of erythema multiforme (EM) is probably hypersensitivity reaction to human herpes simplex virus tipe 1 (HSV-1). Lesions on lips with HAEM can be treated by corticosteroid and acyclovir topically and/or orally. The objective of this study wasto report the case of HAEM with painful ulcers accompanying with crust on lips. A 55 years old woman complained painful ulcers with crust on lips since the last five months. She had visited a primary health care service and received several medications such as antibiotic (ciprofloxacin), anti-inflammatory drug (corticosteroid), analgesic (mefenamic acid) but her complaint was never healed completely because it was always recurring. The lesion on her lips got worse when she ate hot and spicy food and after she went out for outdor activities. She had a history of herpes virus infection seven months before but it was completely healed after treated by acyclovir topically and amoxicilin orally. An extra oral examination found black brown crust on her upper lip vermillion, well-demarcated, irregular margin, rough surface, erythematous surrounding area, accompanied with pain. An intra oral examination identified ulcers, yellowish, 4-5 mm in size, well-demarcated, irregular margin, redness in surronding area, accompanied with pain. Acomplete blood count examination, serology test for HSV-1 (IgM and IgG) were taken and the result showed that only IgG was reactive. The therapies given to the patient were topical medications with a combination of corticosteroid, chloramphenicol and moisturizer, followed by methyl prednisolone and acyclovir orally. After 6-week treatment, the lesions were completely healed.Herpes-associated erythema multiforme (HAEM) caused by hypersensitivity reactionto herpes simplex virus type 1 (HSV-1) may have a characteristic of painful ulcers accompanied with crust on the lips. The combination of both anti-inflammatory and antiviral drugs can be a choice for the therapy.

Introduction: Herpes Associated Erythema Multiforme (HAEM) is Erythema multiforme (EM) caused herpes virus infection.  EM a caused by an acute hypersensitivity reaction that occurs in the mucocutaneous area. HAEM is hypersensitivity reaction that occurs due to a hypersensitivity reaction to the herpes virus. Case: 17 year old male complaints of itching and dry on his lips since 5 days ago. patient said that ± 7 days ago he had a fever which lasted for 2 days then after the fever went down his lips felt itchy and dry. On clinical examination, desquamation with yellowish brown crusts was found on the vermilion of the upper and lower lips. Case Treatment: patient is given Aloclair® Gel and Becomzet®. Patient is referred for a complete blood count, Total IgE and IgM and IgG HSV-1 antibody testing. The patient was then given hydrocortisone cream 2.5% used 3 times a day. The patient recovered 10 days after the first visit. Discussion: HAEM is triggered by an immunological response in which an immune complex reaction occurs as a result of an immune response to certain antigens such as the herpes simplex virus or certain types of drugs. In cases of HAEM the herpes virus that triggers it is usually HSV-1 & HSV-2. Diagnosis is confirmed by Total IgE and HSV-1 Antibody Tests. Conclucion: Management of cases of HAEM can be successfully determined by establishing the correct diagnosis which requires investigations so that we can rule out the differential diagnosis and provide appropriate treatment

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