Mod 7 Pathology ulcers & ulcer like lesions Flashcards
What is Actinomycosis?
bacterial infection that develops from trauma (EX: dental surgery) it is an indurated, ulcerative lesion that develops into a fistula. It is caused by Actinomyces israelii bacterium. Treat with penicillin.
A Chancre may occur during which stage of Syphillis?
Primary Stage
Least common spot to have an ulceration with Lupus
Ventral surface of the tongue.
An ulcer caused by self-induced injury is called?
Factitial
T/F: Erosive lesions are depressed lesions usually with a red border and yellowish center.
True
T/F: Erosive lesions penetrate into the epithelium and extend into the dermis?
False, that would be an ULCER
T/F: Erythema Multiforme may be caused by exposure to certain viral, bacterial, and fungal infections, plus some medications?
True
T/F: Erythema Multiforme MINOR is also referred to as Stevens-Johnson syndrome?
False, that is Erythema MAJOR
T/F: Lupus Erythematosus is an autoimmune disease and Type III hypersensitivity reaction.
True
T/F: Lupus can affect skin surfaces, organs, joins, and serous membranes?
True
Of the (3) RAU’s which is the most common?
RAU minor
T/F: RAU-Minor lesions are less than1cm in diameter and do not leave a scar?
True
What is the largest RAU?
RAU-Major
What is the name of the disease that is associated with RAU-Major?
Sutton’s Disease
Which RAU has 1-10 lesions that are 1-3 cm in diameter, with irregular borders, are deeper crater-like, and cause scarring?
RAU-Major
Which RAU as a prodromal stage, 1-5 lesions and zero scarring?
RAU-Minor
What disease is Neisseria Gonorrhoeae associated with?
Gonorrhea
Neoplasms, infectious diseases-bacterial, viral or fungal, immune disease and hypersensitivity can all cause ________________?
ulcers to form.
Types of trauma that can cause ulcers?….
Factitial, Iatrogenic, chemical, chronic, and acute.
What is an example of a Chronic trauma that could cause an ulcer?
Sharp edge of broken tooth. Remove sharp etch and tissue can finally heal.
What is an example of Acute Trauma?
Pizza burn
What is Necrotizing Sialometaplasia?
trauma caused by surgery or local anes. At junction of hard & soft palate. Salivary gland ischemia that causes tissue necrosis-usually heals 1-3 months.
What is Spirochete Treponema pallidum?
The causative agent of Syphillis.
How many stages of ulcers are associated with Syphillis?
3
Primary Stage:
chancre
very infectious
Secondary Stage:
mucous patch
very infectious
(flu-like symptoms)
Tertiary Stage:
Gumma-soft, non-cancerous.
starts off indurated then turns to ulcer.
Gummas are a type of granuloma.
Clinical signs of Hutchinson’s Triad:
*inflamm of cornea
*deafness
*mulberry molars
*notched incisors
T/F: Gonorrhea can cause blindness.
True. If an area where they don’t put antibiotics in eyes at birth.
Predisposing factors of N.U.G
*stress
*poor nutrition
*systemic probs
*poor HC
What causes NUG, and what are some Oral manifestations?
*Multiple oral spirochetes
involved
*Gingival bleeding, *ulcerations,
*tissue necrosis,
*PAIN,
* punched-out papilla,
gray pseudomembrane
over necrotic tissue,
* fetid breath
Treatment of NUG?
*soft diet
*salt water rinse
*3% peroxide/water rinse
*gentle cleaning
*reduce stress
*chlorhexidine
*antibiotics?
-stay away from irrigating devices!
What are some sources of fungal infections?
*soil
*bird/bad poop
*decaying vegetation
T/F: some fungal infections can produce oral ulcerations?
True. Rare, mostly medical compromised patients. This can indicate a very serious disease-need referral
What type of tissue do Apthous ulcers usually appear?
non-keratinized
T/F: Apthous ulcers are infectious?
False, they are of immune etiology.
Manifestations of apthous ulcers:
*stress
*hormonal changes
*trauma
*genetics
*dental work
*food allergies
*B12 deficiency
3 RAU names?
RAU-Minor
RAU-Major
RAU Herpetiform
RAU that is smaller (1-3mm), 10-100 in clusters that coalesce, and usually found ventral side of tongue and floor of mouth?
RAU Herpetiform
Erythema Multiforme
associate with exposure to certain viral, bacterial, & fungal infections plus some medications (penicillins & barbiturate)
Two types of Erythema Multiforme
Erythema Minor
Erythema Major
round, distinct lesions
lighter red on edges
darker red in center
50% will have oral lesions are all characteristics of which type or erythema multiforme?
Erythema Minor
*AKA Steven’s-Johnson
Syndrome.
*often triggered by meds
*lesions in oral cavity,
conjunctiva, &
genitalia,
*lesions on lip are crusty,
bleedy ulcers
*5-15% MORTALITY RATE
Erythema Major
2 “types” of Lupus Erythematous.
DLE:
Discoid Lupus Erythematous: chronic form that makes up 70% of cases.
SLE:
Systemic Lupus Erythematous: Acute form that affects multiple organs @ a time.
Clinical features of Lupus Erythematous
*butterfly rash on bridge
of nose & cheeks
*Type III hypersensitivity
reaction
*autoimmune disease
*affect skin surfaces,
organs (esp kidneys)
joints, and serous
membranes
*gingiva may have
desquamative
appearance
*oral lesions 20-40% of
time
Important note about Lupus if on Medical History!!!
- Lupus may cause damage to heart valves, pt will need PREMED
*From mouth ~ anus
*lobular oral lesions
can be ulcerated
*higher incidence of
apthous ulcers
*slow healing
are characteristics of what disease?
Crohn’s disease
T/F: the most common oral cancer is Squamous cell carcinoma?
True
*Erythroplakia lesions are
usually either dysplastic
or malignant.
*Speckled Erythroplakia
are mixed red/white
lesions
Squamous cell carcinoma details
signs that are HIGHLY suspicious and can be squamous cell carcinoma:
*ulcerated erythroplakia
*speckled erythroplakia
MOST FREQUENT SITES FOR SQUAMOUS CELL CARCINOMA?
*ventral side of tongue
*lateral border of tongue
*floor of mouth & adj ling
tissue
*retromolar areas
*oral pharynx & tonsillar
regions
