Lecture 10 - Oral Ulcers Flashcards Preview

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Flashcards in Lecture 10 - Oral Ulcers Deck (16)
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1

Two Types of Causes of Oral Ulcers

Local and Systemic

2

Local causes of oral ulcers

Burns, trauma
Aphthous stomatitis (canker sores)
Malignant neoplasms
Drugs
Infectious diseases

3

Systemic causes of oral ulcers

Mucocutaneous disease
Blood disorders
GI disease (Crohn's, ulcerative colitis, Celiac)
Rheumatic disease
Vasculitides
Endocrine disorders (diabetes)
Drug reactions (chemotherapy)

4

Approach to Diagnosis of Oral Ulcers

Recurrent?
How many?
How long?
Medical history
History of trauma
Clinical appearance
Lab tests

5

Findings that suggest Systemic cause

Skin lesions
Ocular lesions
Anogential lesions
Purpura
Fever
Lymphadenopathy
Splenomegaly
Chronic cough
Weight loss
Fatigue
GI complaints

6

Most common ulcers

Trauma or aphthous stomatitis

7

Infectious diseases that cause ulcers

Syphilis
TB
Viral infections
Deep fungal infections
ANUG (Acute Necrotizing Ulcerative Gingivitis)
HIV

8

Systemic Mucocutaneous diseases that cause ulcers

Lichen planus
Pemphigus
Pemphigoid
Erythema multiforme

9

Systemic Blood disorders that cause ulcers

anemia
leukemia
neutropenia
myelodysplastic syndromes

10

Recurrent Aphthous Stomatitis

Canker sores
Very common - 20-66% prevalence
Usually younger patients

11

RAS Risk Factors

Males
Low serum insulin
Family history
Less common in non-Hispanic Black population

12

RAS Clinical Features

Recurrent
Painful ulcers on movable mucosa
Last 7-14 days

13

RAS Classic Classification

Frequency, Ulcer size, and Duration

Minor - most common
Major
Herpetiform - rare (4%)

14

RAS Alternative Classification

Based on duration only

Type A: lesions last a few days, a few times a year
Type B: Painful lesions occur monthly, last 3-10 days
Type C: Painful, chronic lesions

15

Minor Aphthous

55-70%
Recur every 2-3 months

Prodrome
<1cm
Painful
Well defined oval lesion with gray-yellow necrotic center and erythematous periphery
Heals in ~10days without scar
Lymphadenopathy

16

Major Aphthous

Sutton's Disease
10-15%
Often chronic

>1cm
Posterior mucosa, oropharynx
Painful, may cause dysphagia
Can scar