oral ulcerations

Question 1

what are the different classifications of ulcers?

Answer 1

• traumatic (physical, chemical, thermal)
• iatrogenic - drug induced
• idiopathic - recurrent apthous stomatitis

ulcers preceded by blisters (vesicles or bullae)
- infective (viral e.g. herpes simplex)
- autoimmune (mucous membrane pemphigoid, pemphigus vulgaris)

Question 2

if the ulcer is of traumatic origin how long after would you want to review to check it is healing?

Answer 2

no longer than 3 weeks

Question 3

what are some key examples of drug induced oral ulceration?

Answer 3

• methotrexate
• nicorandil
• bisphosphonates
• NSAIDs

Question 4

what can pts also take which reduces their risk of ulceration if they are taking methotrexate?

Answer 4

follate supplements

Question 5

how would you describe ulcers from nicorandi?

Answer 5

large deep and persistent

Question 6

what causes majority of ulcerations in pts taking oral bisphospohonates?

Answer 6

inadequate indigestion - allowing tablet to dissolve in mouth - chemical burn

Question 7

what is the definition of recurrent aphthous stomatitis?

Answer 7

recurrent ulcers confined to the mouth seen in the absence of systemic disease

Question 8

what is the difference between recurrent aphthous stomatitis and recurrent aphthous like stomatitis?

Answer 8

recurrent aphthous LIKE stomatitis ulcers appear very similair to RAS but they are associated with an underlying disease (e,.g. GI diseases)

Question 9

what are the 3 types of recurrent aphthous stomatitis?

Answer 9

minor (80%)
major (10%)
herpetiform (10%)

Question 10

describe minor RAS

Answer 10

These are the most frequent, accounting for 80% of RAS cases. They are generally 10mm or smaller in diameter, appear in crops of up to 10, and usually occur inside the lips, cheeks, tongue, and sometimes the floor of the mouth. They heal within 10-14 days without scarring.
painful

Question 11

describe major RAS

Answer 11

Less common (10-15% of RAS cases), these ulcers are larger than 10mm in diameter. They can occur singly or in clusters (2-3 at a time), anywhere in the mouth. They heal with scarring and can persist for weeks to months.

Question 12

describe herpetiform RAS

Answer 12

The least common type (5-10% of cases), these ulcers appear as numerous (up to 100) small, pinpoint ulcers that may coalesce into larger, irregular-shaped lesions. Despite the name, they are not associated with herpes simplex virus. They heal without scarring and within 10-14 days

Question 13

what is the aetiology for recurrent aphthous like stomatitis?

Answer 13

stress
menstrual cycle
hypersensitivity to foods
GI tract disease
anaemia, haematinics deficiency
drug history
smoking cessation
famoly history

Question 14

what is Behcet’s disease

Answer 14

Behcet’s disease, also known as Behçet’s syndrome, is a chronic inflammatory disorder that affects multiple parts of the body, particularly the blood vessels (vasculitis)
, joints, and eyes. It’s characterized by inflammation and can cause a range of symptoms, including painful mouth and genital sores, skin rashes, eye inflammation, and joint pain