Oral Ulceration Flashcards
what are some immunological causes of mucosal ulceration?
- aphthous ulcers
- lichen planus
- lupus
- vesiculo-bullous
- erythema multiforme
what are some gastrointestinal diseases that can cause mucosal ulceration?
- Crohn’s disease
- Ulcerative colitis
What is the ulcer free period?
How long does the patient go without any ulcers (if its 6 months plus the treatment will be different for a patient with recurrent ulcers)
What should you note on examination of an ulcer?
Margins = flat? raised? rolled?
Base = soft? firm? hard?
Surrounding tissue = inflamed? or normal
Systemic illness involvement
What might a single episode of oral ulceration be caused by?
- Trauma (eg ortho wires)
- 1st episode of recurrent oral ulceration
- primary viral infections
- oral squamous cell carcinoma
What are some causes of recurrent oral ulceration?
- aphthous ulceration
- lichen planus
- vesiculobullous lesions
- recurrent viral lesions (HSV, VSV)
- trauma
- systemic disease
What is an example of a trigger for recurrent aphthous stomatitis?
haematinic deficiencies
How do Crohn’s specific ulcers present?
- linear at depth of sulcus
- full of crohn’s associated granulomas
- persist for months
How are ulcers related to trauma treated?
- identify and remove cause of trauma
- follow up and check ulcer is healing within 2 weeks
What are the characteristics of recurrent herpetic ulcer lesions?
- ulceration limited to one nerve group/branch
- often hard palate
- patient often aware of prodrome and vesiculation which bursts
What does pain associated with recurrent herpetic lesions suggest?
Herpes ZOSTER rather than simplex
How are recurrent herpetic ulcer lesions treated>
Systemic ACICLOVIR
If an ulcer is recurrent but self-healing, and only affects the non-keratinised mucosa, what does this suggest it is?
Aphthous ulcers (commonest recurrent oral ulceration type)
