[4] Symptoms include sudden fever with sore throat, headache, loss of appetite, and often neck pain.

Within two days of onset, an average of four or five (but sometimes up to twenty) 1 to 2 mm diameter grayish lumps form and develop into vesicles surrounded by redness.

Over the next 24 hours, these become shallow ulcers, rarely larger than 5 mm diameter that heal in one to seven days.

[5] A small number of lesions (usually two to six) form in the back area of the mouth, particularly the soft palate or tonsillar pillars.

The lesions progress initially from red macules to vesicles and lastly to ulcerations, which can be 2–4 mm in size.