Oral Manifestations of Some Systemic Diseases

Question 1

Scarlet Fever

Answer 1

Fiery red tongue
Prominent papillae (Raspberry tongue)
White-coated tongue which hyperemic papillae project (Strawberry tongue)

Question 2

Measles

Answer 2

Spotty enanthema in oral cavity, often precedes skin rash

Ulcerations on buccal mucosa about Stensen duct produce Koplik spots

Question 3

Infectious mononucleosis

Answer 3

Acute pharyngitis
Tonsilitis may cause coating with gray-white exudate membrane
Enlargement of LN in the neck
Palatal petechiae

Question 4

Diphtheria

Answer 4

Dirty white, fibrinosuppurative, tough, inflammatory membrane over tonsils & retropharynx

Question 5

Human Immunodeficiency Virus

Answer 5

Predisposition to opportunistic oral infections (esp Candida & other fungi)
Oral lesions of Kaposi sarcoma
Hairy leukoplakia

Question 6

Lichen planus

Answer 6

Reticulate, lacelike, white keratotic lesions that sometimes ulcerate and rarely form bullae

Question 7

Pemphigus

Answer 7

Vesicles and bullae prone to rupture, leaving hyperemic erosions covered in exudates

Question 8

Bullous Pemphigoid

Answer 8

Oral lesions (mucous membrane pemphigoid) resemble those of pemphigus but can be differentiated histologically

Question 9

Erythema multiforme

Answer 9

Maculopapular, vesiculobullous eruption that sometimes follows an infection elsewhere, ingestion of drugs; development of cancer, or a collagen vascular disease

Stevens-Johnson syndrome- when widespread mucosal & skin involvement

Question 10

Pancytopenia (agranulocytosis, aplastic anemia)

Answer 10

Severe oral infections in the form of gingivitis, phayngitis, tonsillitis; may produce cellulitis of the neck (Ludwig angina)

Question 11

Leukemia

Answer 11

With depletion of neutrophils, oral lesions may appear like those in pancytopenia

Question 12

Monocytic leukemia

Answer 12

Leukemia infiltration and enlargement of gingivae, often with accompanying peridontitis

Question 13

Melanotic pigmentation

Answer 13

May appear in Addison disease; hemochromatosis, fibrous dysplasia of bone (Albright syndrome), and Peutz-Jeghers syndrome (gastrointestinal polyposis)

Question 14

Phenytoin (Dilantin) ingestion

Answer 14

Striking fibrous enlargement of gingivae

Question 15

Pregnancy

Answer 15

A friable, red, pyogenic granuloma protruding from the gingiva (“pregnancy tumor”)

Question 16

Rendu-Osler-Weber syndrome

Answer 16

Autosomal dominant disorder with multiple congenital aneurysmal telangietasias beneath mucosal surfaces of the oral cavity and lips