Red Surface Lesions

Question 1

Traumatic Ulcer

caused by

can last

Answer 1

• Caused by simple mechanical trauma
• Or by factitious or iatrogenic
• Acute or chronic

Question 2

Aphthouos Ulcer

Cause

Occurs on

2 diff names

app

Tx

Answer 2

• Cause unknown but not infectious
• NON-keratinized tissue
• Minor, Major Herpetiform
• Red halo surrounding central yellow/white area
• Tx Corticosteroids

Question 3

Herpes Simplex

Commonly caused by

incidence

app

triggers

Answer 3

• HHV1 most common
• US incidence 80-85%
• 1-3mm vesicles –>ulcerate
• Triggers
  
  • Sunlight
  • Tissue injury and inflammation
  • Physical or emostional stress

Question 4

Primary Herpes

Occurs on

Usually have

Tx

Answer 4

• Keratinized AND non-keratinized
• Usually have fever, malaise, lymphadenopathy
• May be subclinical
• Tx
  
  • within first 3 days of symptoms
  • Acyclovir suspension
  • Rinse and swallow 5 times daily
  • Children 15mg/kg
  • Adults 200mg

Question 5

Recurrent Herpes

Occurs on

Symptoms

Tx

Answer 5

• Keratinized tissue only
• Recurs in same location
• No fever, malaise, lymphadenopathy
• Prodrome precedes lesions
• Tx
  
  • Valacyclovir 1 g tablet
  • Disp 4 tablets
  • 2 tabs at onset, then 2 12 hrs after

Question 6

Herpes Zoster

Cause

App

Answer 6

• Recurrent Vaicella infection HHV3
• Unilateral distribution on skin and dermatome

Question 7

Generalized Vesiculoerosive Lesions

Long duration 4

Short 1

Short or long 1

Answer 7

• Long duration Months
  
  • Pemphigus vulgaris
  • Pemphigoid
  • Erosive Lichen Planus
  • Lupus
• Short duration days
  
  • Erythema multiforme
• Short or long
  
  • Drug induced mucositis

Question 8

Nikolsky Sign

Seen in 2

What is it

Answer 8

• Seen in pemphigus vulgaris and mucous membrane pemphigoid
• Induction of bullae by lateral pressure or application of air

Question 9

Pemphigus Vulgaris

Cause

App 2

Demonstrates

Answer 9

• Autoimmune attacking epithelial desmosomes
  
  • Intraepithelial splitting
• Generalized ulcerations of skin and or mucosa
• Nikolsky sign may be present
• Demonstrates immunoglobin fluorescence

Question 10

Mucous Membrane Pemphigoid

Cause

App 2

Demonstrates

Answer 10

• Autoimmune attacking epithelial HEMI-desmosomes
  
  • Subepithelial splitting
• Skin, mucosa, and EYE involvement
  
  • Symblepharon formation which may lead to blindness
  • Must see opthalmologist
• Nikolsky sign may ne present
• Immunoglobin fluorescence

Question 11

Lupus Erythematosus

Cause

Commonly affects

Systemic

Chronic

Answer 11

• Autoimmune women more common
• Systemic lupus
  
  • multisystem: heart endocarditis, kidney renal glomeruli (glomerulonephritis) butterfly rash on face
• Chronic
  
  • aka discoid lupus only skin and oral

Question 12

Erythema Multiforme

Cause

Predisposing factors

Forms 3

Key features 3

Answer 12

• Cause unknown
• Predisposing factors
  
  • Half the time preceded by herpes pneumonia or medications
• Minor form, major form (Steven Johnsons) and Toxic Epidermal Necrolysis
• Key features
  
  • Acute onset days of gen oral ulcerations
  • Target lesions (not always)
  • Black crusty lips

Question 13

Chrons Disease

Cause

Symptoms 2

Orally 4

Answer 13

• Inflammatory bowel disease affecting anywhere from oral cavity to anus
• Lesions mainly in small intestine
• May cause rectal bleeding
• Orally
  
  • Labial swelling
  • Aphthous like ulcers
  • Mucosal tags
  • Granulomatous gingivitis