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

Red Lesions Flashcards by Marina Pitcher

Vesicle vs ulcer

Vesicle may lose overlyring epithelium and become an ulcer

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Epidermolysis Bullosa

Genetic

Cause

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

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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

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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

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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

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HSV Latency and Reactivation

Remains latent in regional nerve ganglion
Reactivation cause is unknown, assoc with
- UV
- Trauma
- Immunosuppresion
Prodrome: tingling, burning

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Recurrent Herpes

Apperance

Assoc

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

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Herpetic Withlow

Infection of fingers

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Herpes gladiatorum or scrumpox

Wrestles, rugby with contaminated abrasions

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Herpes Barbae

Herpes over bearded region into minor injuries from shaving

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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

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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

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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

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Hand foot mouth disease

Cause

Symptoms

Apperance

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

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Herpangina

Cause

Symptoms

Apperance

Dist

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

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Measles

Cause

Apperance

Dist

Paramyxovirus
RNA virus spread via respiratory droplets
Apperance
- Kopliks spots
- Mucosal erythema
- Small blue white macules
- Buccal labial mucosa

Errosive Lichen Planus

Cause

Apperance Dist

Assoc

Immune abnormality, oversensitive T cells
Lichenoid drug rxns
Graft vs host
Apperance
- Erythema, painful erosions and ulcers white striae periphery
- Vesicles are rare
Dist
- Bilateral, focal or multifocal
Assoc
- Atrophy of filiform papilae
- Oral candidosis common

Pemphigus Vulgaris

Cause

App

Dist

Histo/Biopsy

Autoantibodies to desmosomes
App
- Blisters rupture easily forming painful ulcers
- Nikolsky sign
Dist
- Large areas of skin/mucosa
- Usually Multifocal
Histo Biopsy
- Tzanck cells
- 2 samples one in formalin, Michels soln
Tx
- Corticosteroids
- Fatal w/o tx

Mucous Membrane Pemphigoid

Cause

App

Dist

Prognosis

Antibodies against hemidesmosomes
App
- Vesicles and painful ulcers
- May heal with scarring
- Erythematous gingiva
- Chronic desquamative gingiva
- Nikolsky
Dist
- Extraoral- Conjunctiva
- Nasal, pharyngeal, vaginal mucosa
- Skin
Prognosis
- good, monitor eye lesions
Tx
- Corticosteroids mouthrinses

Bullous Pemphigoid

Cause

App

Vs MMP

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

Systemic Lupus

Cause

App

Dist

Assoc

Symptoms

Severe multisystem disease
Inc activity of B cells and abnormal T cells function
App
- Butterfly rash, worsens in sun
- Oral lesion uncommon
- Lichenoid or non-specific
- Chronic desquamative gingivitis
Dist
- Palate, buccal mucosa, gingiva
Assoc
- Kidney failure, cardiac involvement
Symptoms
- fever weight loss arthritis fatigue malaise

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

Ulcerative Lesions Autoimmune/idiopathic 6

* Apthous ulcers * Erythema multiforme * Drug reaction * Contact stomatitis * Wegners granulomatosis * Chrons disease

Traumatic Ulcer

* Mechanical trauma * Loc * Lower lip tongue buccal mucosa

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

Aphthous Ulcers Cause Types Common app

* Cancker sores * T cell mediated immunologic reaction * Types * Minor major Herpetiform * Ulceration with a white pseudomembraneous membrane surrounded by a red halo

Minor Aphthous Uceration Occurance lesions size Healing

80% cases 1-5 lesions **3-10mm** **Heal in 7-14 days** **No scarring**

Major Aphthous Ulceration lesions siz healing prog

* 1-10 lesions * **1-3cm** * **Healing 6 wks** * **More frequent recurrence** * **May cause scarring**

Herpetiform Athous Ulceration lesions size Dist Healing Ressembles

* 10-100 lesions * 1-3mm * May coalesce * Heal 7-10 days * May look like herpes but isnt bc it doesnt occur on kerat and non-kerat

Behcets Syndrome

* Serious multisystem disease * Aphthous-like ulcers, genital ulcers, occular inflammation, skin pustules

Erythema Multiforme Cause Predisposing factors Forms

* Blistering, ulcerative mucocutaneous condition of **unknown cause** * Prob immunologically mediated * Predisposing factors * 50% of cases **preceded by herpes or pneumonia** * Meds AB analgesics, sulfanimodes * Forms * **Minor Major Toxic epidermal nercrolysis**

Erthema Multiforme Onset Symp Skin lesions Oral lesions

* **Acute onset appear suddenly** * May have fever malaise (never lymphadenopathy) * Skin * **Iris or target lesion**: erythematous macule with central vesicle * Oral lesions * **Diffuse painful ulcers, may have vesicles** * **Lips** buccal labial mucosa