Oral ulceration Flashcards
Recurrent ulceration
these affect around 20% of population + occur again + again in same pt, usually with no diagnosed cause, although linked to nutritional deficiencies in some pts
- minor aphthous ulcers
small, shallow, painful ulcers that heal within 14 days + cause no scarring
- major aphthous ulcers
large, painful ulcers that take weeks or months to heal + cause scarring
- herpetiform aphthous ulcers
very small multiple ulcers that occur sometimes up to 100 at at time
Ulceration due to systematic disease
various diseases affecting the digestive system often exhibit oral ulceration, + should be noted in the medical history:
Crohn’s disease, ulcerative colitis, coeliac disease + inflammatory bowel disease
Ulceration due to viral infection
- herpes simplex - as primary infection of pt with this virus, causing ulceration of most oral soft tissue + recurring throughout later life as herpes labialis (cold sores)
- coxsackie virus - hand, foot + mouth disease in childhood with small ulcers in these areas + specifically on soft palate + back of mouth
Ulceration due to skin disorders (lichen planus)
inflammatory skin condition causing ulceration
oral lesions are recognised as being premalignant i.e. they can undergo cell mutation + develop into malignant (cancerous) lesions
ulcers appear orally with white striae (stripes) around them
Malignant ulceration
squamous cell carcinoma is predominant manifestation of oral caner + usually develops as ulceration in flow of mouth or sides of tongue:
1.
painless ulcer with no obvious cause, such as trauma from sharp tooth which doesn’t heal within 2-3 weeks of its first appearance
2.
aphthous like ulcer with a ‘punched out’ floor + rolled edges - classic appearance of an advanced malignancy
3.
very usually (not always) diagnosed in smokers, users of other tobacco products + heavy drinkers
