5. Ulcerated lesions

Question 1

What is an ulcer?

Answer 1

Localised surface defect with loss of surface epithelium exposing underlying inflamed connective tissue

Question 2

What are the 7 types of causes for oral ulceration?

Answer 2

• infective
• traumatic
• drugs
• idiopathic
• associated with systemic disease
• associated with dermatological disease
• neoplastic

Question 3

What is important when diagnosing a traumatic ulcer?

Answer 3

must identify a cause for a traumatic ulcer, otherwise further investigation is required

Question 4

What is the overall histopathology of oral ulceration?

Answer 4

a large proportion of ulcers will show non-specific fractures, ulceration with loss of surface epithelium, inflamed fibrinoid exudate and inflamed granulation tissue

obvious exceptions e.g. neoplastic lesions

Question 5

What is the difference between a vesicle and a bulla?

Answer 5

size - vesicle is a small blister, bulla is a blister >10mm

Question 6

How do vesiculobullous lesions usually present?

Answer 6

as oral ulceration following rupture of vesicles/bullae

Question 7

What are immunobullous disorders?

Answer 7

autoimmune diseases in which autoantibodies against components of skin and mucosa produce blisters.

a subset of vessiculobulous lesions

Question 8

How can disorder which result in vesicles/bullae be classified histologically?

Answer 8

depending on the location of the bulla
1. intraepithelial
2. subepithelial