I'm sorry to hear that you're experiencing persistent oral lesions despite treatment. Oral lesions spreading to the mouth and outer lips can have various causes, and since Tretiva 10 (which contains isotretinoin, primarily used for severe acne) has not provided relief, it suggests that your condition might require a different approach.

Here are some important steps you should consider:

• Consult a dermatologist or an oral medicine specialist: They can perform a thorough examination and may recommend additional tests such as biopsy or cultures to identify the exact cause of your lesions.
• Consider other possible causes: Oral lesions can be due to infections, autoimmune conditions, allergic reactions, or other dermatological diseases that may not respond to isotretinoin.
• Avoid self-medicating further: Since isotretinoin is not typically used for oral lesions, continuing it without improvement may not be beneficial and could cause side effects like dryness or irritation.
• Maintain good oral hygiene: Use gentle oral care products and avoid irritants such as spicy or acidic foods.
• Seek urgent care if symptoms worsen: If you develop severe pain, difficulty eating or swallowing, fever, or spreading of lesions, seek immediate medical attention.

Given the complexity and persistence of your symptoms, I strongly recommend seeing a dermatologist or an oral medicine specialist promptly for a detailed evaluation and tailored treatment plan.To narrow down potential causes, we will need some more information.I understand you're dealing with persistent oral lesions and haven't found relief with treatments like Tretiva 10. To better assist you, could you please provide your age and gender?