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Vaping left a young woman with bloody and crusty mouth ulcers that doctors thought were caused by herpes.
The 22-year-old from Indonesia went to doctors complaining of the sores inside and around her mouth that were so painful she couldn't eat or drink.
The doctors tested the patient for herpes but her results came back negative.
After quizzing her about lifestyle changes it was revealed she had started using e-cigarettes around a year prior to her symptoms flaring up.
WARNING: GRAPHIC CONTENT
The 22-year-old woman had been vaping several times a week for the past year when she developed sores in and around her mouth (stock photo)
Doctors were able to finally diagnose her with oral erythema multiforme, a type of skin condition similar to an allergic reaction that is rarely seen in and around the mouth.
The academics, revealing the case in a US medical journal, said it was likely 'vape-related'.
They pointed out that erythema multiforme can be triggered by certain substances in e-cigs, such as propylene glycol, glycerin, nicotine, flavorings or other toxins.
Erythema multiforme affects around 200,000 people in the US each year - usually caused by an infection such as herpes or bacterial or fungal infections.
Symptoms include pink and red skin and mouth lesions that can sometimes be itchy or painful, as well as joint pain, fever and itching.
The condition can occur all over the body and it is rare to be solely confined to the mouth.
Minor cases of the skin condition can clear up on their own, while more involved cases may need to be treated with steroids, allergy medications, antiseptics or antivirals depending on the root cause.
In extreme cases, hospitalization may be required if the patient is unable to eat, is in extreme pain or severely dehydrated. Doctors may also apply cool compresses and administer antibiotics.
The woman visited doctors at the Department of Oral Medicine at the University of Indonesia complaining of mouth sores and pain over the previous month. She had trouble eating due to the ulcers and pimples in and around her lips and mouth.
Doctors observed sores on her inner cheeks, tongue, roof and floor of the mouth and lips, with crusts and 'an erosive' area at the corner of her mouth that bled.
Above are photos from the patient's case report that show her condition when she first visited the doctors
The patient revealed to doctors she had been using vaping devices for about a year, but had never experienced an issue.
Shortly before her symptoms began, the woman, who had never smoked traditional cigarettes, switched vaping liquids to try another flavor.
She told doctors she began vaping 'out of curiosity' and would smoke e-cigarettes a few times a day every few days with friends.
The patient's case was considered a 'mild' form of erythema multiforme and she was given a steroid mouthwash, as well as a solution to moisten gauze with and apply to her lips three times a day.
She was also sent home with a cream to apply to the eroding wound area on the side of her mouth and instructed to apply Vaseline to her dry lips throughout the day.
Doctors also stressed she should stop vaping.
In just one week, the patient showed vast improvement.
Vaping has been associated with a number of health side effects, including mouth and throat irritation, eye irritation, shortness of breath, fatigue and lung cancer.
It is estimated nearly 31million Americans vape or use electronic cigarettes, including 2million middle and high school students.
Advertised as a safer alternative and smoking cessation aid for traditional cigarettes, the vaping industry has come under fire for its marketing that targets young kids and lack of long-term data on how the devices effect people's health.
Vaping is becoming such a public health issue in the US that the Department of Justice and the FDA created a task force this week to combat the sale of unauthorized e-cigs and vaping products.
Officials and critics argue the unregulated vaping products are purposely designed for and marketed to children with their colorful packaging and fruity or candy-like flavors.
Acting Associate Attorney General Benjamin Mizer said these products 'jeopardize' the health of children and adolescents across the US and the task force will be 'dedicated to protecting Americans by combatting' their illegal distribution.
Officials added the group will include multiple government agencies overseeing guns, drugs, the US Postal Service and the marshal service to coordinate efforts to investigate and prosecute for criminal and civil crimes.