Oral Ulceration Flashcards
Triggers that may cause recurrent aphthous stomatitis
Behcets
HIV
SLS toothpaste
Genetics
Causes of ulcerations
- Trauma
- Immunological
- Carcinoma
- Infections (viral)
- Gastrointestinal
Immunological causes of ulcerations
Aphthous ulcers
LP
Vesiculobullous disease
Lupus
GI causes of ulcerations
Crohns
Ulcerative colitis
Questions to ask as part of an ulcer history
Where
Size + shape
Blister or ulcer
How long has it been there for?
Is it recurrent - same or diff site
Is it painful
Common viral infections that cause ulceration (2)
Coxsackie virus
Herpes zoster + herpes gingivostomatitis
3 types of RAU
Minor
Major
Herpetiform
Examples of VBD that can cause ulcers (4)
Pemphigoid
Pemphigus
Angina bullosa haemorrhagica
Erythema multiforme
Describe the appearance of crohns specific ulcers
Linear fissured ulcer along depth of sulcus (not round oval)
Full of crohns associated granulomas
Persist
What to consider when examining an ulcer
Margins
- Raised, rolled, flat
Base
- Soft, firm, hard
Surrounding tissue
- Inflamed, normal
Systemic illness
- Temp, crohns, ulcerative cohlitis
Protocol for ulcer
Follow up in 2wks
If still persistent biopsy required to rule out malignancy
Features of recurrent herpetic ulcerated lesions
- Ulceration limited to one nerve group/branch
- Often hard palate
- Lesions recur in same place
Why is it importance to suppress viral replication in cases of herpes zoster
Recurrence associated with increased nerve damage and possibility of persisting nerve pain after lesion settled
Tx for recurrent herpetic lesions
Systemic aciclovir
Prophylatic follow on
