Soft tissue swellings Flashcards
What are the locljslised causes of intra oral swellings?
Cystic Neoplastic Reactive Inflam Vascular Developmental Infective Traumatic
What are the diffuse causes of swellings?
Angioedma OFG Oral crohns Sarcoidosis Allergic chelitis Irritational chelitis Metabolic disease eg acromegaly
What is a common drug cause of angiodeme?
Ace inhibitors
What are the features of angiodema?
Pronounced swelling labial and peri orbital.
What is the complication of angiodema?
Airway blocked!
How do you manage severe angioedemA?
If there is any threat to the airway then IM adrenaline with systemic corticosteroids or antihistamines
How do you manage mild angiodema?
Antihistamines
What is OFG?
Chronic or recurrent swelling of orofacila tissue with not evidence of GI involvemtn
What does the histopathology of crohns show?
Non caseating epitheliod granulomas where there is no other cause can be found histologically
T/F in OFG there is perivermillion erythema
T
T/F there are mucosal tags in OFG?
T
What special investigations should be done on OFG?
- Exclude the presence of fungi and mycobacterium using special stains eg D/PAS and ZN
- Exclude the presence of foreign material
What is the diff diagnosis of OFG?
Oral crohns
Melkersson Rosenthal syndrome
Sarcoidosis
Allergic reaction eg angioedemA
What percentage of cases do orofacila signs precede intestinal involvemtn in OFG?
60%
Which dietary substances must people with OFG avoid?
Benzoates and cinnamon free
How do we manage OFG?
Topical and syestmic
What topical agents do we use in OFG and crohns?
Intralesions steroids eg triamcinalone acetonide
Topical steroids: adocortyl in steroids
Topical immunosuppressants :
What systemic agents do we use in OFG and crohns ?
Steroids
Anti microbials eg dapson
Immunosuppressants eg azothiarpine
What is the difference between crohns and PFG?
Clinically identical but crohns has a proven gut involvement
T/F the GI involvement in crohns is not always symptomatic?
T
T/F you can get aphthous ulcers in Crohsn?
T
What is pyostomatitis vegetans? What is it a marke for?
Oral condition associated with pustules and ulcers or erosions
IBD
How do you manage crohns?
Need to mange gut and mouth
Anti TNF alpha drug eg infliximab
Same as OFG
