What is the diagnosis and treatment for painful bumps on the upper lip that have been present for a week and are bleeding?

Diagnosis: Herpes Labialis (Herpes Simplex Virus Type 1 Infection)

Ang diagnosis ay herpes labialis, isang viral infection na sanhi ng herpes simplex virus type 1, na nagpapakita ng masakit na mga butlig (vesicles) sa labi na nagiging sugat. 1, 2

Medical Assessment

Ang pasyente ay may:

• Masakit na mga butlig (vesicles) sa itaas ng labi na nagsusugat
• 1 linggo na ang sintomas
• Typical presentation ng recurrent herpes labialis 1, 3

Ang diagnosis ay clinical based sa classic grouped lesions (papules, vesicles, ulcers) sa labi. 2 Hindi na kailangan ng laboratory confirmation para sa typical presentation. 1

Treatment Plan & Recommendations

Oral Antiviral Therapy (Pinakamabisa)

Acyclovir 400mg tablet, 1 tablet taken twice daily (umaga at gabi) for 5 days 2, 3

• Dispense: 10 tablets total
• Estimated cost: ₱150-200 (within budget)
• Dapat simulan agad ang treatment para sa optimal results 1, 2

Supportive Care (Kasama sa treatment)

White soft paraffin ointment (petroleum jelly), apply sa labi every 2 hours 1, 4, 5

• Dispense: 1 small tube (15g)
• Cost: ₱30-50
• Para sa protection at moisture ng labi 4

Warm saline mouthwash, 4 times daily 1, 4, 5

• Gumawa ng saline solution: 1 teaspoon salt sa 1 glass warm water
• Rinse mouth for 1 minute, then spit out 1
• Para mabawasan ang bacterial colonization 4

Pain Management

Paracetamol 500mg tablet, 1 tablet every 6 hours as needed for pain 6

• Dispense: 12 tablets
• Cost: ₱30-40
• Take 20 minutes before eating kung masakit 6

Total Medication Cost: Approximately ₱210-290 (within ₱300 budget)

Important Instructions

• Avoid touching or picking at the lesions - nakakahawa ito sa ibang tao at sa ibang parts ng katawan 2, 3
• Avoid kissing or sharing utensils/cups habang may active lesions 2
• Avoid alcohol-containing mouthwashes - mas masakit ito 1, 4, 5
• Balik kung hindi gumaling after 2 weeks para sa reevaluation 4, 5

Explanation of Condition

Ang herpes labialis (cold sores) ay viral infection na sanhi ng herpes simplex virus type 1. 1, 2 Ito ay:

• Nakakahawa - kumakalat through direct contact sa lesions 2, 3
• Recurrent - pwedeng bumalik dahil ang virus ay nananatili sa katawan 1, 2
• Self-limiting - gagaling din kahit walang treatment, pero mas mabilis gumaling with antiviral medication 1, 2
• Triggered by stress, fever, sun exposure, or illness 1

Ang oral acyclovir ay mas effective kaysa topical creams at shortens the duration of pain and discomfort, hastens healing, and reduces viral shedding. 2, 3 Dapat simulan ang treatment within 48 hours from onset of lesions para sa optimal results. 2

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Medical Certificate

This certifies that [PATIENT] has been seen and examined today with the diagnosis of: Herpes Labialis (Herpes Simplex Virus Type 1 Infection) and recommendation of: Oral antiviral therapy with Acyclovir 400mg twice daily for 5 days, supportive care with white soft paraffin ointment application every 2 hours, warm saline mouthwashes 4 times daily, and Paracetamol 500mg as needed for pain. Avoid direct contact with lesions. Follow-up if not improved after 2 weeks.