2nd Week Discussion Flashcards
clinical features of erythema multiforme (3)
Clinical features EM minor: –Skin (extremities) –Mucosa (oral, conjunctival, genitourinary, respiratory) –Hemorrhagic crusting of vermilion zones
ID
Erythema multiforme
describe the erythema multiforme lesions on skin (2)
Variety of appearances “multiforme”
• Round, dusky-red patches on skin of
extremities “target lesions
” • Bullae with necrotic centers
Erythema multiforme (EM)
• Erythematous patches oral mucosa
that undergo necrosis and result in
large, shallow erosions and ulcers with
irregular borders
Erythema multiforme
erythema multiforme
clinical features of erythema multiforme major
–2 or more mucosal sites in conjunction
with skin lesions
• Mucosal, lip and skin lesions as seen
in EM minor
–Ocular involvement can produce
symblepheron
Erythema multiforme (EM) • Treatment (supportive therapy):
–Systemic or topical steroids early on
–IV re-hydration
–Topical anesthetic or analgesic for pain
(controversial)
“Punched-out” interdental papillae
Necrotizing Ulcerative Gingivitis
Severe pain, oral malodor, spontaneous
hemorrhage
Necrotizing Ulcerative Gingivitis
describe Necrotizing Ulcerative Gingivitis (3)
“Punched-out” interdental papillae
Localized or diffuse gingival involvement
Severe pain, oral malodor, spontaneous
hemorrhage
Necrotizing Ulcerative Gingivitis
Necrotizing Ulcerative Gingivitis
Necrotizing Ulcerative Gingivitis
NUG - Treatment (4)
Debridement (using topical or local anesthesia)
Mild salt water rinse or chlorhexidine
Improve oral hygiene and diet
Broad spectrum antibiotic may be helpful,
particularly if systemic symptoms
aka – Herpetic Gingivostomatitis
Primary Herpes
describe symptoms of primary herpes
Acute fever, cervical lymphadenopathy, oral sores
Small ulcers often coalesce, resulting in larger
ulcers having serpentine borders
Primary Herpes
primary herpes
primary herpes
ID + tx
first 2-3 days–> acyclovir or valacyclovir (valtrex)
Symptomatic care – analgesics, antipyretics
Topical anesthetics so patient can eat and
drink – important to avoid dehydration
Popsicles can be soothing for pediatric
patients
how long does primary herpes last?
10 to 14 days
primary herpes has an approximately _____chance of developing at
least one episode of recurrent disease
Approximately 25% chance of developing at
least one episode of recurrent disease
Recurrent Herpes Two forms:
Recurrent Herpes Labialis
Recurrent Intraoral Herpes
aka – cold sore, fever blister
Recurrent Herpes Labialis
Recurrent Herpes Labialis affects where?
Affect vermilion zone or perioral skin
symptoms of Recurrent Herpes Labialis (5)
Prodromal itching, tingling, burning, erythema
followed by cluster of vesicles
what happens with Recurrent Herpes Labialis with no treatmet
With no treatment, vesicles rupture, form a
crust, and lesions heal in 7-10 days
Recurrent Herpes Labialis
Recurrent Herpes Labialis
Recurrent Herpes Labialis