Oral Manifestations of haematological disease

Question 1

Infections in immunocompromised???

Answer 1

Patients with bone marrow failure
Patients on chemotherapy
HIV positive haemophiliacs
Agents
–	Viruses – eg herpes
–	Bacteria
–	Fungi – eg candida

Question 2

Herpes Simplex (cold sore) infection in neutropenic pt

Answer 2

White spots on lips

Question 3

Oral ulcers due to herpes in immunocompromised pt

Answer 3

Tongue ulcers

-send viral/ bacterial/ fungal cultures to see what specific agent is

Question 4

Neutropenic ulcer in aplastic anaemia

Answer 4

 Bone marrow fails and stops making blood cells
 No neutrophils – frequent infections
 Extensive mouth ulcers

Question 5

Glandular fever (infectious mononucleosis)

Answer 5

Both tonsils very inflamed

Question 6

Oral candida albicans infection

Answer 6

A lot more white patches in immunocompromised

Question 7

Bleeding

Answer 7

Thrombocytopenia
Haemophilia
Warfarin
Other inherited bleeding disorders
Scurvy

Question 8

Petichiae in glandular fever

Answer 8

??

Question 9

Conjuntival haematoma in Immune Thrombocytopenic Purpura (ITP)

Answer 9

Does not effect the eye

Platelets are very low (10 instead of 200-400?)

Question 10

Spontaenous bleeding in aplastic anaemia

Answer 10

Check blood count

• leukaemia
• ??

Question 11

Mucosal Purpura in Acute Myeloblastic Anaemia???

Answer 11

**

Question 12

Periorbital haematoma due to injury in haemophilia

Answer 12

Requires several days of treatment

**

Question 13

Mouth haematoma in haemophilia

Answer 13

Require treatment: otherwise tongue can end up blocking airway

Question 14

Poor dentition in haemophilia due to reluctance to have procedures

Answer 14

Scared

Question 15

Haemophiia - Oral Hairy Leukoplakia in HIV +ve

Answer 15

Need to be referred to biopsy

Question 16

Vitamin C deficiency (scurvy)

Answer 16

Causes bleeding

Question 17

Ehrlos-Danlos syndrome

Answer 17

Hyperextensible skin

Bleeding - collagen is abnormal

Question 18

Infiltration

Answer 18

Lymphoma e.g. tonsillar
Gum hypertrophy e.g. Acute monocytic leukaemia
Macroglossia due to amyloid deposition

Question 19

Gum infiltration in acute monocytic leukaemia

Answer 19

Something seriously wrong
Can grow candida on top
M5

Question 20

Macroglossia due to mayloid deposition

Answer 20

Can be quite disabling

Question 21

Others

Answer 21

Angular stomatitis in iron or B12 deficiency
Smooth tongue in iron or B12 deficiency
Cyanosis (can be due to congenital heart disease)
Hereditary haemorrhagic telangiectasiae (HHT)
-dots around nose?
Ulcers in vit B12 deficiency
Maxillary hypertrophy due to extramedullary haemopoiesis in thalassaemia major
Hereditary angioneurotic oedema