Oral Manifestations Flashcards
(24 cards)
What is oral ulceration?
Discontinuity in the oral mucosa
can present as a solitary ulcer or multiple ulcers
What is the first thing to exclude upon presentation of a solitary ulcer?
physical or chemical trauma
What are possible causes of ulcers?
they can be caused by a huge range of conditions as well as infection and as a side effect of drugs
Causes of solitary ulcers
trauma
malignancy - oral squamous cell carcinoma
infective - TB - primary or secondary infection of mycobacterium
tuberculosis also tertiary syphilis
Causes of multiple mouth ulcers
RAU - Recurrent aphthous ulceration (potentially stress related) 3 types major, minor and herpetiform
Bechets
Anaemia
Mucocutaneous disorders
What needs to be ruled out when there are multiple ulcers
haematinic deficiency and GI disease
What is Bechets
a multisystem condition
hereditary systemic vasculitis
oral ulcers almost identical to RAU, genital ulceration, uveitis, erythema nodosum
What is the oral presentation of anaemia?
Mucosal pallor
Oral ulceration
Glossitis (tongue inflammation)
Angular chelitis (red, swollen patches at the corners of your mouth)
Predisposition to candida (fungal infection)
Disturbed taste
Mucocutaneous disorders resulting in mouth ulcers
Lichen Planus
Vesiculobullous disease - Pemphigus and Pemphigoid
Lupus Erythematosus
Presentation of lichen planus
bilateral mouth ulcers
asymtomatic
can affect the skin
potentially malignant
Presentation of lupus erythematosus
Oral manifestation ulceration White patches Red and white patches Similar in appearance to lichen planus (can be discoid or systemic)
Presentation of VB - pephigus vulgaris
- oral lesions often first manifestation
- painful extensive oral ulceration
Presentation of VB- pemphigoid
- benign mucous membrane pemphigoid
- painful oral ulceration
- blisters more likely
- affects mucous membranes of other organs
What GI diseases cause malabsoption and consequent haematinic deficiency leading to oral manifestation
Crohns
Ulcerative Colitis
Peutz Jegher
Gardeners Syndrome
Oral Manifestation of Crohns
- may present before abdominal symptoms Cobble-stoning of mucosa Localised mucogingivitis Linear ulceration Tissue tags/polyps Diffuse swelling – commonly of the lips ( OFG) Pyostomatitis vegetans
Oral manifestations of Ulcerative Colitis
Oral ulceration
Pyostomatitis vegetans
Angular stomatitis
the oral symptoms reflect the severity of the intestinal disease
What can white patches indicate
if wipe off - usually pseudomembranous candidasis/ thrush if don't wipe off - trauma epithelial dysplasia neoplasia chronic mucocutaneous candidasis
What are the causes of oral pigmentation?
Racial pigmentation Melanotic macules malignancy smoking Addison's Disease - excess ACTH/MSH released from the pituitary in response to reduced corisol levels
What can reults in xerostomia?
dry mouth can be a result of
drugs
sjogren’s
radiation therapy
What are the oral manifestations of Sjogren syndrome?
Enlarged salivary glands As a result of dry mouth: Increased caries Depapillated tongue, fissured Red dry wrinkled mucosa Increased predisposition to candida
What is Sjogren’s syndrome?
Dry eyes and dry mouth, commonly affects females - primary or secondary
secondary - associated with autoimmune disease
Oral manifestations of leukaemia?
Gingival enlargement (enlarged gums) Petechiae (purple, red or brown spots) Mucosal bleeding Ulceration Infiltration by malignant cells Boggy gingiva (gum ulcers) Presentation due to underlying immuno-compromise: Candida Herpes infection Opportunistic infection
What are the oral manifestations of lymphoma?
Palpable lymphnodes
Extra/intraoral diffuse swellings
Ulceration
Tooth migration/mobility
What are the oral manifestations of HIV?
Ulceration Kaposi’s sarcoma HPV lesions Salivary gland swelling As a result of immunosuppression Increased risk of malignancy
