Chapter 2 - Ulcerative Diseases Flashcards
Oral Ulcerations (based on etiology)
Mechanical Ulcers
Chemical ulcers
Thermal ulcers
Traumatic Ulcers
Most common
- Acute (red rim): Pain, yellow base; 7-10 day healing
- Chronic (white rim): little/no pain; elevated margin; delayed healing
What are examples of acute ulcers?
Thermal burn
Chemical burn
Mechanical trauma
Apthous ulcers
What are examples of chronic ulcers?
- Mechanical trauma
- Traumatic granuloma with stromal eosinophilia (TUGSE) *granulation tissue*
- Necrotizing sialometaplasia
- Lichen planus/lichenoid mucositis
- Deep fungal infections
- Bacterial infections
- Squamous cell carcinoma
Chemical ulcers
- Patient induced: Aspirin (coagulative necrosis)
- Iatrogenic: 30% Hydrogen Peroxide; tooth etching agents, phenol containing medications, radiation during chemotherapy (path of radiation), and phenol containing medications
Histopathology of TUGSE
Syphilis
Causative agent: Treponema pallidum
Primary: chancre
Secondary: Oral mucous patches, condyloma latum, maculopapular rash
Tertiary: Gummas (palatal perforation); CV or neurosyphilis; mucosal atrophy
Congenital Syphilis: saddle nose, saber shin and Hutchinson’s triad (Interstitial keratitis, 8th nerve deafness and mulberry molars)
Primary Syphillis Differential Diagnosis
- Chronic traumatic ulcer
- Squamous cell carcinoma
- Other infectious diseases (TB, etc.)
Secondary Symphilis Differential Diagnosis
Infectious and non-infectious conditions marked by mucucutaneous eruption (TB, etc.)
Tertiary syphilis Differential Diagnosis
- T-cell Lymphoma
- Deep fungal infection
- Salivary gland neoplasms
Histopathology of Syphilis
- In primary and secondary lesions: plasma cell infiltration
- In gummas: necrosis and granulomatous lesions
