Oral Ulceration Flashcards

1
Q

What can cause ulceration on the mucosa?

A
  • Trauma
  • Immunological
  • Carcinoma
  • Infections
  • Gastroinstestinal
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2
Q

What immunological reactions can cause ulceration?

A
  • Aphthous ulcers
  • Lichen planus
  • Lupus
  • Vesiculo-bullous
  • Erythema multiforme
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3
Q

What gastrointestinal reactions can cause ulcerations?

A
  • Chron’s disease
  • Ulcerative colitis
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4
Q

What are the Key features of Oral ulceration History?

A
  • Where
  • Size and shape
  • Blister or ulcer
  • How long for
  • Recurrent (Same site, different site)
  • Painful
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5
Q

What are the key points you need to consider when examining an ulcer?

A
  • Margins - Flat? Raised? Rolled?
  • Base - Soft? Hard? Firm?
  • Surrounding tissue - Inflamed? Normal?
  • Systemic illness?
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6
Q

What trauma can cause a single episode oral ulceration?

A
  • Denture
  • Appliance
  • Sharp tooth or restoration edge
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7
Q

What does this picture show?

A
  • 1st episode of recurrent oral ulceration
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8
Q

What does this picture show?

A
  • Primary Viral infection producing ulceration
  • Most common virus Coxsackie and Herpes virus
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9
Q

What does this picture show?

A
  • Oral squamos cell carcinoma
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10
Q

What are some examples of Recurrent Oral Ulceration?

A
  • Aphthous ulceration (can be minor/major/herpetiform)
  • Lichen planus
  • Vesiculobullous lesions
  • Recurrent viral lesions - HSV/VZV
  • Trauma
  • Systemic disease i.e. Chrohns
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11
Q

What type of Ulcers can Chrohns disease pts present with and why?

A
  • Aphthous type ulcers due to haematinic deficiency and are oval in shape
  • Chrohns specific ulcers
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12
Q

What type of ulcers does this picture show?
- Describe them

A
  • Chrohns specific ulcers
  • Linear fissure pattern of ulcers at the depth of the sulcus
  • Can persist for months and require intralesional steroids to help
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13
Q

What are the findings with traumatic ulceration?

A
  • Common
  • Usually single episode but can be recurrent if cause is not removed
  • Normal or abnormal epithelium
  • Remove cause and should heal in about 2 weeks
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14
Q

What would you do if the traumatic ulceration has not healed in 2 weeks after removing the cause?

A
  • Biopsy to ensure not an early malignancy
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15
Q

What has caused this traumatic ulceration?

A
  • Chemical burn on the lip mucosa
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16
Q

What has caused this type of traumatic ulceration?

A
  • LA administration in child which has caused them to bite and chew on the mucosa
17
Q

What are recurrent herpetic lesions?

A
  • Ulceration limited to one nerve group/branch
  • Herpes simplex or herpes zoster
18
Q

When recurrent herpetic lesions occur on the hard palate what are the findings?

A
  • Occur in same place
  • Pt aware of prodrome and vesiculation which bursts
  • Pain suggestes Herpes Zoster not simplex
19
Q

What is the txt of recurrent herpetic lesions?

A
  • Aciclover 5%
  • Apply up to 4 times a day on affected lesion as soon as symptoms start
20
Q

What is the generak rule for Ulcerations?

A
  • Recurrent self-healing ulcers affecting exclusively the non-keratinised mucosa are most likely aphthae ulcers
  • Recurrent ulcers affecting keratinised ulcers tend to be viral
  • Traumatic ulcers tend to occur in areas of teeth or denture
21
Q
A