Red Lesions Flashcards
Vesicle vs ulcer
Vesicle may lose overlyring epithelium and become an ulcer
Epidermolysis Bullosa
Genetic
Cause
Tx
Apperance
- Familial hx, congenital or childhood
- Defect in the attachment mechanisms of the epithelial cells
- No cure
- Management: supportive
- Vessicles and bullae due to minor trauma
- Oral lesions
- bullae heal with scarring
- Hypoplastic teeth
Viral Diseases
Gen symptoms
- Acute onset
- May have malaise, fever, lymphadenopathy
- lymphadenopathy not present in recurrent herpes and zoster
- Multiple ulcers
- All have vesicle stage except infectious mononucleosis
- Herpes and zoster are the ony recurring ones
Human Herpes Virus 1-8 names
- HHV 1- HERPES SIMPLEX
- HHV2- HERPES SIMPLEX
- HHV3- VARICELLA ZOSTER
- HHV4-EPSTEIN-BARR
- HHV5- CYTOMEGALOVIRUS
- HHV6- ROSEOLA VIRUS
- HHV7- ROSEOLA-LIKE
- HHV8- KAPOSI SARCOMA
HSV Primary Herpes
Age
Symptoms
Distribution
- Usually children, adults too
- Most are asymptomatic
- Symptoms
- lymphadenopathy
- malaise fever diarrhea
- Enlarged gingiva, red painful
- Multiple vesicles and ulcers, may coalesce
- Ulcerations must be on keratinized AND non-keratinized
HSV Latency and Reactivation
- Remains latent in regional nerve ganglion
- Reactivation cause is unknown, assoc with
- UV
- Trauma
- Immunosuppresion
- Prodrome: tingling, burning
Recurrent Herpes
Apperance
Assoc
Tx
- Vessicles and ulcers
- in small clusters
- On vermilion border, perioral skin and limited to keratinized oral mucosa
- Recur in same location each time
- Vermillion border common-herpes labialis
- Lymphadenopathy NOT present
- Tzanck cells
- Tx Valacyclovir taken during prodrome
Herpetic Withlow
Infection of fingers
Herpes gladiatorum or scrumpox
Wrestles, rugby with contaminated abrasions
Herpes Barbae
Herpes over bearded region into minor injuries from shaving
Varicella-zoster Chickenpox
symptoms
Causes
- Prodrome: malaise, fever lymphadenopathy
- Succesive crops of pruritic papules, vesicles, ulcers
- Begin on trunk and spread to extremeties and face
- occasional oral vesicles
Herpes Zoster (shingles)
What is it
Predisposing factors
Apperance distribution
Side effects
- Latent stage of Varicella
- Zoster represents a recurrence
- Predisposing factors
- immunosuppresion due to cancer, chemo, corticosteroids
- Elderly
- Prodrome
- Vesicles and ulcers
- Unilateral
- follows peripheral nerve distribution
- Post-herpetic neuralgia-pain in nerve distribution
Infectious Mononucleosis
Virus
Assoc
Symptoms
Oral mucosa apperance
- Epstein Barr HHV4
- Assoc with
- Burkitts lymphoma
- Nasopharyngeal carcinoma
- Hairy leukoplakia
- Fever malaise cervical lymphadenopathy, pharyngitis
- Oral mucosa
- erythomatous
- Petechiae on palate
- Ulcers WITHOUT vesicles
Hand foot mouth disease
Cause
Symptoms
Apperance
Tx
- Coxsackievirus grp A
- Flu like sysmptoms
- malaise mild fever diarrhea
- Vesicles and ulcers throughout oral cavity (1st to appear)
- Macules and vesicles on hands and feet
- Tx
- tylenol
- Clears in 5 days
Herpangina
Cause
Symptoms
Apperance
Dist
tx
- Coxsackievirus grp A
- Symptoms
- Fever, pharyngitis, nausea, vomiting, diarrhea, lymphadenopathy
- App
- similar to HFM but confined to posterior cavity
- Soft palate, uvula, tonsilar pillar
- tx
- resolves in several days
Bullous Pemphigoid
Cause
App
Vs MMP
Tx
- Antibodies against hemidesmosome
- Most common autoimm blistering condition
- App
- Skin lesions always present, thick bullae/ulcers
- Oral lesions uncommon- bullae rupture sooner than skin, large shallow ulcers distinct margins
- Chronic desquamative gingivitis
- Compared to MMP
- BP more limited and doesnt scar
- Tx corticosteroids
Chronic Cutaneous Lupus
Aka
Location
Symptoms
App
- Aka discoid lupus erythematosis
- Confined to skin and oral cavity
- Few or systemic signs/symptoms
- App
- Scaly erthematous patches
- Frequent in sun exposed skin
- Scarring and pigmentation
Subacute Cutaneous Lupus
Clinical manifestations
Type of lesions
Freq in
Symptoms
Assoc w/
- Clinical manifestations intermediate btw SLE and CCLE
- Cutaneous lesions
- Freq in sun exposed
- No scarring or Pigmentation
- Renal changes absent
- Arthritis and mucoskeletal
Chronic Desquamative Gingivitis
App
Found in 4 diseases
- Diffuse slougjing of gingiva
- Erosive lichen planus
- Pemphigus
- Pemphigoid (MM or bullous)
- Lupus
Acute Erythematous Candidosis
Occurrence
Symptoms
App
Tx
- Most common form
- Generalized pain, burning
- Erythema, diffuse loss of filliform
- Broad spectrum AB
Chronic Erythematous Candidiasis
- Common in denture wearers aka denture stomatitis
- Erthematous area where denture touches palate
- May cause burning or asymptomatic
- May not be caused by candida
Canida Median Rhomboid Glossitis
Loc
- Anterior to circumvallate papilla
- Kissing lesion on palate may be present
