Oral Ulceration Flashcards
Single episode ulceration - potential causes
trauma
1st episode of recurrent oral ulceration
primary viral infections
oral squamous cell carcinoma
Causes of oral ulceration
trauma
immunological
infections
carcinoma
gastrointestinal
recurrent oral ulceration - potential causes
aphthous ulceration
- minor
- major
- herpetiform
lichen plants
vestibullous lesions
- pemphigoid, pemphigus
- angina bulls haemorrhagica
- erythema multiform
recurrent viral lesion
- HSV, VZV
trauma
systemic disease
- Crohn’s disease ulceration
Crohn’s disease ulcers
mixture of ulcer types
- aphthous type ulcers - behaviour like aphthous ulcers - associated with haematinic deficiency
Crohn’s specific ulcers
- Linear at depth of sulcus
- full of Crohn’s associated granulomas
- persist for months - intralesional steroids help
oral ulceration features - what you need to find out
where
size and shape
blister or ulcer
how long?
- more than 2 weeks?
recurrent
- same site? different sites?
pain
ulcer examination - things to check
margins
- flat, raised or rolled?
base
- soft, firm, hard?
surrounding tissue
- normal or inflamed
systemic illness
traumatic ulceration features
common
usually single episode
- can be recurrent if cause is not remade
normal or abnormal epithelium
heals in about 2 weeks once cause removed
recurrent herpetic lesions - features
ulceration limited to one nerve group/branch
often hard plate
- lesion recurs in same place
- patient often aware of prodrome and vesicle which bursts
- pain suggests herpes zoster rather than simplex
recurrent herpetic lesions - treatment
acyclovir
- use as prophylaxis is a severe problem
recurrent aphthous stomatitis types
minor
major
herpetiform
Behcet’s syndrome
Which type of ulcers are generally aphthous?
recurrent self healing ulcers which exclusively affect non-keratinised mucosa
