OM- Ulceration Flashcards
Single episode ulceration examples
Trauma
First episode of recurrent oral ulceration
Primary viral infection- herpes
Oral SCC
Crohn’s disease oral ulcer presentation
Apthous type ulcer- haematinic associated
Crohn’s type granulomas
Linear at depth of sulcus/buccal mucosa
Persistent for months
Traumatic ulcers
Single episode related to trigger- remove cause
Heal in about 2 weeks
What do u examine when checking an ulcer
Margins
Base
Surrounding tissue
Systemic illness
Recurrent herpetic lesions
Often on hard palate
Limited to 1 nerve branch
Painful= herpes zoster not simplex
Treat with aciclovir 800mg 5xD for 7D
What is difference between apthous ulcers and non apthous ulcers
Recurrent ulcers affecting non-keratinised tissue will be apthous whilst those affecting keratjnised tissue will be viral
What are recurrent apthous ulcers
Immunologically derived recurring ulceration in epithelium and connective tissue of oral mucosa
Genetically driven with environmental triggers
RAU types
Minor
Major
Herpetiform- rarest
Oro-genital ulcer syndrome- Behcet’s syndrome
Minor apthous ulcer features
Non-keratinised oral mucosa
<10mm diameter
Last up to 2 weeks
Heals without scarring
Good response to topical steroids
Major apthous ulcers features
Any part of oral mucosa
>10mm diameter
Lasts for months
May leave scar when healed
Poor response to topical steroids
Herpetiform apthous ulcers
Non-keratinised oral mucosa
Multiple<2mm diameter
Last up to 2W
No fever
Behcet’s disease features
3 episodes of mouth ulcers yearly
Genital sores, eye inflammation, skin ulcers, pathergy
Pathogenesis of Behcet’s disease
Vasculitic inflammation of blood vessels
Behcet’s disease management
Colchicine
Immune modulating- azathioprine/mycophenolate
Biologics- infiximab
Rheumatology
RAU immunological process
Basal cell layer damaged, no longer producing new epithelial layers
Superficial epithelium lost over time
Ulcer presents when connective tissue exposed- Tx most effective before connective tissue exposed
