IMMUNOLOGIC DISEASES (RECURRENT APHTHOUS - canker sore) Flashcards
1
Q
CONCEPT
A
RECURRENT PAINFUL ULCERS OF THE ORAL MUCOSA (NONKERATINIZED MUCOSA - BUCCAL MUCOSA/TONGUE/SOFT PALATE/FAUCES/FLOOR OF MOUTH)
2
Q
ASPECT
A
- ULCERS WHITE/GRAY/YELLOW SURROUNDED BRIGHT RED HALO
- ULCERS NOT PRECEDED BY VESICLES
3
Q
CAUSE
A
- UNKNOWN
- T CELL-MEDIATED IMMUNOLOGIC
- ALLERGIES/GENETIC PREDISPOSITION/HORMONAL INFLUENCES/INFECTIOUS AGENTS/NUTRITIONAL DEFICIENCIES/SMOKING CESSATION/STRESS/TRAUMA
4
Q
FORMS
A
- 3 (MINOR/MAJOR/HERPETIFORM APHTHOUS ULCERS)
- ALL PAINFUL/PATIENTS OCCASIONALLY HAVE PRODROMAL SYMPTOMS OF TINGLING OR BURNING BEFORE LESIONS
5
Q
DIFFERENTIAL DIAGNOSIS
A
LOCATION: IMPORTANT SIGN SEPARATION APHTHOUS ULCERS/SECONDARY HERPETIC ULCERS
6
Q
MINOR APHTHAE
A
- MOST COMMON (80%)
- SINGLE/PAINFULL/OVAL ULCERS (LESS 1 CM DIAMETER)/COVERED YELLOW FIBRINOUS MEMBRANE/SURROUNDED ERYTHEMATOUS HALO
- LAST 7/10 DAYS / HEAL WITHOUT SCAR
- FEWEST RECURRENCES/SHORTEST DURATION OF 3
- 1/5 LESIONS PRESENTS SINLGE EPISODE
- BUCCAL/LABIAL MUCOSA
7
Q
MAJOR APHTHAE
A
- LARGER/DEEPER THAN MINOR APHTHAE
- LONGEST DURATION PER EPISODE
- 1/3 CM DIAMETER
- PERSIST UP TO 6 WEEKS / HEAL WITH SCAR
- NUMER LESIONS 1-10
- LABIAL MUCOSA/SOFT PALATE/TONSILLAR FAUCES
- HIV PATIENTS (COMMON)
8
Q
HERPETIFORM ULCERS
A
- GREAST NUMBER LESIONS/MOST RECURRENCES
- MULTIPLE/SMALL/DIFFUSE/PAINFUL/SUPERFICIAL ULCERS
- 1-3 MM
- UP 100 ULCERS
- ULCERS COALESCE INTO A LARGER IRREGULAR ULCER
- ULCERATION HEAL 7-10 DAYS WITHOUT SCARING
- MOVABLE MUCOSA (MORE)/PALATAL/GINGIVAL MUCOSA
- UNLIKE HERPES INFECTION, HERPETIFORM APHTHOUS ULCERS ARE NOT PRECEDED BY VESICLES AND EXHIBIT NO VIRUS-INFECTED CELLS*
9
Q
SYSTEMIC DISORDERS (ASSOCIATED)
A
CROHN’S/BEHCET’S SYNDROME/CELIAC SPRUE/AIDS/CYLIC NEUTROPENIA/NUTRITIONAL DEFICIENCIES
10
Q
TREATMENT
A
PALLIATIVE (DISCOMFORT) TOPICAL ANESTHETICS/TOPICAL CORTICOSTEROIDS (BETAMETHASONE GEL/0.05% FLUOCINONIDE GEL)
