Ulcerated Lesions Flashcards
In conclusion…
oral ulcers can be caused by various reasons
trauma, infections, immunological issues
manifestation of systemic diseases
biopsy may be requied for diagnosis
Acute ulcer:
painful, yellow base, red halo, history of trauma
Chronic ulcer:
elevated margins, delayed healing, mimics oral cancer
Riga-Fede disease:
ulcer on tongue of neonates due to trauma from erupting teeth
T-cell mediated immunological reaction which affects 20% of the general population
- Presence of highly antigenic reagent
- Decrease in mucosal barrier
- Abnormal response to common antigen
Aphthous Ulcers
Minor Aphthous Ulcerations (Mikulicz aphthae)
80% of the cases
1-5 lesions
Between 3-10 mm
Heal in 7-14 days
Major Apthous Ulcerations (Sutton’s disease)
10% of the lesions
1-10 lesions
Between 1-3 cm
Heal in upto 6 weeks
Herpetiform Aphtous Ulcerations
10% of the cases
10-100 lesions
Between 1-3 mm
Heal in 7-10 day
Erythema Multiforme
50% of cases associated w/ herpes and pneumonia
blistering, ulcerative mucocutaneous disorder
Erythema Multiforme
Acute onset, with wide spectrum of severity (oral lesions only -> entire skin
Erythema Multiforme
Large, shallow, irregular erosions and ulcerations which emerge quickly
Erythema Multiforme
Hemorrhagic crusting of the vermillion zone of the lips
Erythema Multiforme
Stevens-Johnson syndrome (EM major):
oral and skin + ocular/genital lesions
Erythema Multiforme
Toxic epidermal necrolysis (Lyell’s disease):
diffuse sloughing of skin
Contact Allergy
Acrylic resin
Contact Allergy
Toothpaste
Contact Allergy
Cinnamon
Contact Allergy
Amalgam
Drug Allergy
Methotrexate
Drug Allergy
Nicorandil Ulcer
Crohn’s Disease
inflammatory disease that may affect any part of the digestive tract
Teenagers, w/ second peak > 60y
GI issues (cramps, pain, diarrhea)
wieght loss and malnutrition
Wide range of oral lesions
Precede GI lesions in 30% of cases
Non-caseating, chronic granulomatous inflammation
Wegener’s Granulomatosis (Granulomatosis with polyangiitis)
Strawberry gingivitis
Wegener’s granulomatosis
Deep and irregular ulcerations
Mycobacterium tuberculosis
2 million deaths/year
HIV increases risk
Poverty and crowding
Alcoholism, malnutrition, etc
Transmitted from person to person through saliva droplets in the air
Tuberculosis
Chronic painless ulcer
usually due to secondary infection
caused by Mycobacterium leprae
Initial infection often in nasal and oropharyngeal mucosa
“Leonine Faces”
Thick skin nodules
Hansen’s Disease (Leprosy)
Strong immune response
Localized disease
Hipopigmented macules
Neural involvement
Tuberculoid (paucibacillary)
Weak immune response
Multiple lesions
Macules, papules, nodules
Neural involvement
Lepromatous (multibacillary)
caused by Treponema pallidum
sexual relations, blood transfusion, vertical transmission
huge issue in the 40s until the discovery of penicillin by Alexander Fleming
The great imitator
Syphilis
Hutchinson’s triad: hutchinson’s teeth, ocular interstitial keratitis and eight nerve deafness
Congenital syphilis
Gonorrhea
caused by Neisseria gonorrhea
second most common reportable bacteria infections in the U.S.
slighly more common in females
Most commonly seen in oropharynx. Asymptomatic or mildly bothersom
rarely may show necrosis, purulence and hemorrhage of gingiva
diagnosis: culture and antibiotic testing
Histoplasmosis
caused by Histoplasma capsulatum
Dimorphic organism
grows in humid areas with soil enriched by bird and bat excretion
endemic in fertile river valleys, especially ohio and mississippi rivers
Histoplasmosis
Solitary, variably painful ulceration
Resembles malignancy
Usually in tongue, palate and cheek
