Theme 7 - Oral mucosal infections Flashcards
What are the predisposing factors for oral candidosis?
- Immunodeficiency
- Xerostomia
- Smoking
- Head and neck radiation
- Immunosuppression (including steroid inhalers)
- Anaemia
- Diabetes
- Denture wearing
- Suppression of normal oral flora by antibiotics
What is erythematous candidiasis? What is its differential diagnosis?
Most common type. Acute painful lesion, diffuse loss of filiform papillae on dorsum of tongue appearing red, may also affect hard palate. Commonly seen after antibiotic use. Burning sensation, xerostomia, dysgeusia.
B12, folate or iron deficiency
What is pseudomembranous candidosis?
Most common in immunosupressed patients.
Semi-adherent whitish soft plaques (like curdled milk). Wiped off to reveal red underlying mucosa. Any mucosal surface affected. Burning sensation, xerostomia and dysguesia.
What is hyperplastic candidosis/ candida leukoplakia?
Rare form. White plaque infitrated by candidae, usually on commisures of oral mucosa. Mainly seen in heavy smokers. Higher incidence of dysplasia and malignant transformation.
What is denture induced stomatitis?
Diffuse erythema of denture bearing area only, asymptomatic. Predisposing factos = constant denture wearing, poor OH
What are the 3 types of denture induced stomatitis?
Type 1 = localised erythema, pinpoint hyperemia
Type 2 = generalised erythema involving all denture bearing area
Type 3 = papillary type commonly involving central part of palate (palatal papillary hyperplasia)
What is medium rhomboid glossitis?
Reddish surface on dorsum of tongue anterior to circumvallate papillae, once thought to be developmental, now localised chronic candidiasis
What is angular cheilitis?
Symmetrical erythematous fissures on skin of commissures, usually due to C.albicans and Staph. aureus.
What are the predisposing factors for angular cheilitis?
Predisposing factors: decreased vertical dimensions, iron deficiency, hypo-vitaminoses (esp. B), malabsorption e.g. from Crohns disease
Where are lesions found for herpes simplex 1 and 2?
Where does herpes remain latent?
1 = oral, 2 = genital
Trigeminal gangion
What is primary herpetic gingivostomatitis?
What other clinical features accompany this?
Gingivitis - diffuse purple boggy swelling of free gingivae. Stomatitis - 1-2mm blisters, rapidly breaking down to shallow painful ulcers, often affecting lips. Affects 6m-5yrs and early 20s (2 age peaks).
Other features:
Malaise, fever, enlarged cervical LN, loss of appetite, hypersalivation
Recurrent labial herpetic infection (cold sores) can be reactivated how?
- Fever
- UV
- Stress
- Fatigue
- Trauma
- Sideropenia (iron def)
- Immunosupression
- Menstruation
What is recurrent intraoral herpetic infection and what can it be mistaken for?
HSV1 within mouth (less common) usually on keratinised surfaces, crops of ulcers. Can follow palatal LA.
Recurrent aphthous stomatitis
What is varicella (chicken pox) characterised by?
Primary infection, appearance of 2/3 sucessive crops of itchy erythematous papules, evolve to vesicles then to pustules then crusted erosions. Begins on trunk and spreads centrifugally. Also fever malaise etc.
Where does zoster (shingles) occur?
Where is it affecting if involving the Facial nerve at geniculate ganglion?
Pain and rash occur in one dermatome (skin and mucosa supplied by a sensory nerve). Most are in the thoracic region, 30% in trigeminal area.
Ear, ipsilateral palate and tongue, facial nerve palsy, hearing loss, vertigo, tinnitus, nystagmo (Ramsay Hunt syndrome)
