Ulcers in Oral Mucosa

Question 1

Patient present with “snail track “ ulcers in oral mucosa what is the diagnosis ?

Answer 1

Syphilis
Classic characteristic of secondary syphilitische

Biopsy and refer to gp

Question 2

25 year old present with multiple superficial ulcers and pharyngitis
Her swab is reported gram -ve ,intracellular diplocci
Diagnose ?

Answer 2

Gonorrhoea caused by bacterium called ( Neisseria gonorrhoeae bacterium)
Spread by Oro-genital contact

Infect the mucous membranes of reproductive tract
It also infect the mucous membrane of mouth , throat, eyes and rectum

Treatment: dual antibiotic therapy

Question 3

Name a condition which causes vesicular bullous disease and is a type of Hailey-Hailey disease ?

Answer 3

Pemphigus

Question 4

Define oral ulcer

Answer 4

A breach in the epithelium that exposes the underlying connective tissue

Question 5

Name 5 causes of oral ulcers ?

Answer 5

1) Aphthae

2) carcinoma
3) GI tract disease
4) haematological disease
5) infections
6) mucocutanous disorder
7) radiotherapy
8) trauma

Question 6

What are the difference between major and minor aphthae?

Answer 6

Major :

• are more severe
• usually 1 cm or larger in diameter with an irregular outline
• are usually single and affect the fauces ( arches opening at the back of the mouth leading to pharynx)
• much more sever , swept and tendency to bleed
• lasts for weeks , months , heals with scaring
• affect both keratinised and non- keratinised mucosa

Minor :

• commonest form of ulcers
  Less than 1 cm (2-3 mm)
  -occur singly or in crops of up to 10 which last from 3 days to 2 weeks , heal without scaring
  -round or oval with retail at erythema your halo and a grey or yellow base
• affect only non keratinised mucosa

Question 7

Name 3 mucocutaneous casues of Oral ulceration?

Answer 7

1) pemphigus
2) pemphigoid
3) lichen planus
4) erythema multiforme

Question 8

What investigation should be requested in the management of suspected aphtous oral ulceration?

Answer 8

Blood tests ( full blood picture )
Haematinics ( B12, folate , ferritin ) 
Liver function 
Glucose test 
Biopsy

Question 9

What oral conditions happen in patient with HIV?

Answer 9

1) kaposi’s sarcoma
2) oral candidiasis
3) period disease
4) any viral or bacterial infection

But most commonly is the oral candida

Question 10

Which area of the mouth is most commonly affected by burning mouth syndrome?

Answer 10

Tongue 80%

Female =7xmore than male

Question 11

What features of mucosa is most commonly associated with an oral diagnosis of crohn disease ?

Answer 11

Mucosal Tags

Question 12

A patient with angular colitis , you decided to perform some tests. Which tests are they?

Answer 12

Full blood count
Vit B12
Ferritin
Fasting venous glucose

Question 13

What is the make yo female ratio of prevalence of recurrent aphtous ulceration?

Answer 13

1:1

Similar prevalence

Question 14

What is the female to make ratio of patients with burning mouth syndrome ?

Answer 14

Female 7x more than males

Question 15

What is the mean age of presentation in burning mouth syndrome ? And what causes it?

Answer 15

Mean age =60 ( not younger than 45)

Causes are;
\:vit B complex Deficiency 
Haematological disorder 
Undiagnosed type 2 diabetes 
Xerostomia 
Paragunctional habits 
Poorly constructed dentures
Cancer phobia anxiety 
Depression 
Climacteric 
Allergy