herpetiform aphtous ulcers
numourous ulcers, sizes 1-3 mm, not very deep,invisible scars,
location:ventral side of the tongue (fig. 47) - buccal mucosa - floor of the mouth
treatment: corticosteroids (15-40
mg/day for a period of 7 days
and
tetracyclines
herpetiform aphtous ulcers
minus aphtae
SOLAR CHEILITIS (actinic cheilitis)
nicotinic stomatitis
verroucous lekoplakia
actinic chelitis
idiopathic leukoplakia non homo/ erythroleukoplakia
minor aphtae
female population and young adults
burning sensations, paresthesia or local hyperesthesia 24-48 hours prior
round or oval shape and less than 1 cm
very painful, covered by a white-yellowish necrotic tissue/ well circumscribed, with a specific erythematous hallo
Their most common locations are: - labial mucosa - the margins and ventral surface of the tongue - buccal mucosa - vestibule of the mouth - floor of the mouth
Treatment: anti-inflammatory agents kenlog
oral antiseptic solutions LISTERINE®
antibiotic with tetracyline >>>> achromycine
analgesic>>>xylocaine
mandatory to eliminate all local sources of irritation and a thorough oral hygiene will be instituted, together with complete avoidance of spicy, acid or irritating foods and allergenic agents
sloar chelitis /actinic chelitis
premalignant esion / mostly on lower lips ,/ workers / white population
early stage we see mild keratinisation that causes the disappearance of the line between the edge of vermillion and the surrounding skin, then becomes chronic and white patches appear , deffused margins,swallon crustand lips loss their elassticity.
complementary tests: biopsy and histopathalogical examinatins
treatment: prevenntive: sunscreen and ZINC OXIDE based cream
CRYOTHERAPY (FREZZING STUFF)
bechet syndrome
white necrotic ulcers covered by serous exudates, oval ulcers, can be supeficial or profoud,bright red margins
frequent location is on: - lips - gingiva - buccal mucosa - tongue
without leaving any scars,
complementary test:Histopathologic examination
serological examinations
One particularity of Behçet disease is the hypersensitivity of the skin to needle sting that manifests as an erythemal-papular reaction, followed by the formation of a sterile pustule.
treatment: minor>>>>>>s topic steroids administration, painkillers and non-steroid anti-inflammatory medication.
major>>>>>>>>>>>immunosupression meds like corticosteroids(levamisol)
discoid lupus erythematosous
sloar chelitis or actinic chelitis
minus aphtae
WHITE SPONGE NEVUS (Canon disease)
symetrical lesions ,asymptomatic, white and spongy , on jugal mucosa , lateral of the tongue, labial mucosa, floor of the mouth
Histopathologic examination
no treatment required
behcet syndrom
behcet syndrom
nicotinic stomatitis
herpetiform aphtous ulcers
verroucous leukoplakia
SECOND SYPHILIS
2ND SYFLIS
ATrophic glossitis
major aphtous
unilateral , the lesion is profound and it appears crater shape with irreguar bottom , size 1-5cm -necrotic center,no bleed , painful,dysphagia and dysphonia
**** leaves scar>>>exclude malignency
location: lateral and ventral side of the tongue , buccal, labial , palatin tonsil
*treatment: if its gigantic >> bacidracin tablets
*dexametazone
*systemic steroids hydrocortizon
prednizone
all minor treatments
surgical removal
nicotinic stomatitis
actinic chelitis
SECONDARY SYPHLIS
frictional hyperplasia
ertholeukoplakia
behcet syndrome
sclerotic glossitis
discoid lupus erythematosous
SECONDARY SYPHILIS
frictional hyperplasia
Discoid lupus erythematosus (DLE)
Skin lesions develop on sun-exposure
purplish patches on the skin
specific aspect of “butterfly wings” on the face.
The favoured locations of the lesions are: - buccal mucosa - lower lip - gingival fibre-mucosa - tongue
central atrophic red patch with whitish lines disposed as sunrays.
Complementary examinations: direct immunofluorescence test and histopathologic
Treatment :Oral lesions are treated with topical steroid medication
oral administration of corticosteroids or anti-malaria medication.
gumma
gumma
gumma
discoid lupus erythematosous
2NDARY SYPHILIS
discoid lupus erythematosous
???? Homogenous leukoplakia !!!!
idiopathic leukoplakia{thickening of the mucosal layer, hyperkeratinization)
etiology:alcohol, candida albikans60%, mecha, chemic, anemia
Location: jugal mucosa , lips, lateral of tongu, retromolar areas , palate
clicical aspect:assymptomatic burning sensationby irritants, keratotic lesions ……>>>> homogenous: white flat patches..>>> less malignancy
Non-homogenous: white, whiteyellow, gray lesions or white red mixed ……… can be nodular or spicky …..more ratio of dysplasia or malignancy…..>>>>types: verrucous leukoplakia {spicky one} , erytholeukoplakia, nodular leukoplakia
treatment: with dysplasia >>>> co2 laser, surgical crayotherapy
without dysplasia>>>>> retinoid compounds , BETA CAROTHEN
SECONDARY SYPHILIS
2NDSARYSYPHILIS
nodular leukoplakia
TERTIARY SYPHILIS
1/3 OF 1/3 cases of syphilis will develop the third
It is mainly characterized by:
neurological manifestations
cardiovascular lesions
lesions of the skin and mucosa
bone lesions
3 LESIONS
GUMA >>>> HARD PALATE FISTUA
ATROPHIC GLOSITIS
SCLROTIC GLLOSITIS
discoid lupus erythematosous
white sponge nevous
idiopathic leukoplakia
erythroleukoplakia/ non homogenous
major aphtous
erythroleukoplakia
major aphtus
verrucous leukoplakia
minus aphtae
nicotinic stomatitis
heavy smokers pipe smokers no prosthesis appliance starts with deussed erythema and then epithelium gets hyperkeratinazed and become thick . small red dots are covering the orifficess of the salivary glands////location mainly palatin veil
histopathalogical examination
stopsmoking
FRICTIONAL HYPERPLASIA (traumatic keratosis)
: lips, lateral margins of tongue, jugal mucosa along the occlusion plane of teeth
an isolated, white and thickened patch on the mucosa due to orthodontic appliance , eating with odontholous spaces , cheek biting
no complementary test
no treatment needed
major aphtus
primary syphlis
vdrl
tpha
microscopic dark fieldexamination
painless >>>The specific lesion of syphilis is chancre
PENICILIN FOR ALL SYPHLIS STAGES
PRIMARY SYPHILIS
major aphus
PRIMARY SPHILIS
PRIMARY SYPHILIS
nodular leukoplakia
PRIMARY SYPHILIS
major aphtus
white sponge nevous
a dark-red macular eruption -syphilitic rosella, located mainly on the posterior side of the oral cavity
dark field microscopic examination and immunofluorescence examination
TREATMENT PENICILIN
major aphtus
2ND SYPHLIS
frictional hyperplasia
behcet syndrom
atrophic form of lichen planus
red, atrophic not ulcerative
loc: gingiva
c. t general stuff
non -specific clinical aspect is desquamated gingivitis”(fig. 89) and it interests symmetrically each of the four quarters
The symptoms accompanying this condition are irritation, burns or dryness of the mucosa.
treatment :cyclosporine, coricoid creams,TACROLIMUS
reticularform of lichen planus
reticular lichen planus
most common tupe of planus
common location: jugal mucosa bilateral , but also on lips tongue , gingiva
clinical aspect: keratotic lesions called wicham straiae (so many)
C.test: histopathalogical test
immunofluorocense tet
treatment: assymptomatic lesion>>no treatment needed
symptomatic lesion>>>> systemic cyclosporine
reticular lichen planus
most common tupe of planus
common location: jugal mucosa bilateral , but also on lips tongue , gingiva
clinical aspect: keratotic lesions called wicham straiae (so many)
C.test: histopathalogical test
immunofluorocense tet
treatment: assymptomatic lesion>>no treatment needed
symptomatic lesion>>>> systemic cyclosporine
angular chelitis
is a type of chronic candidiasis
bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts
C.T NO NEED
TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field
antifungal antibiotic therapy
chronic atrophic candidiasis (prosthesis candidiasis)
LOCATED MAINLY ON THE HARD PALATE
HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia
pain and burning is common
C.T : immunofluorocense examination
treatment: nystatin sol 100.000u/ml 4times a day
amphotericin B suspension 100mg/ml 4 times a day
miconazole gel 2% 4*aday
new prosthetic device , rigorous oral hygiene
remove the prosthetic at nights
angular chelitis
is a type of chronic candidiasis
bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts
C.T NO NEED
TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field
antifungal antibiotic therapy
angular chelitis
is a type of chronic candidiasis
bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts
C.T NO NEED
TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field
antifungal antibiotic therapy
median rhomboid glositis
is a kind of chronic candidiasis
central papillary atrophy of the tongue
clinicalfeatures: first soft red denudated patch located on the median line of the dorsal side of the tongue ,,,,,,,,,,,,,,,,,later it gets hard and lobulated ,,,,,it is - cm oval or rhombic with rounded borders
median rhomboid glositis
is a kind of chronic candidiasis
central papillary atrophy of the tongue
clinicalfeatures: first soft red denudated patch located on the median line of the dorsal side of the tongue ,,,,,,,,,,,,,,,,,later it gets hard and lobulated ,,,,,it is - cm oval or rhombic with rounded borders
sclerotic glossitis >>>>>median rhomboid glossitis
median rhomboid glositis
is a kind of chronic candidiasis
central papillary atrophy of the tongue
clinicalfeatures: first soft red denudated patch located on the median line of the dorsal side of the tongue ,,,,,,,,,,,,,,,,,later it gets hard and lobulated ,,,,,it is - cm oval or rhombic with rounded borders
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
chronic atrophic candidiasis (prosthesis candidiasis)
LOCATED MAINLY ON THE HARD PALATE
HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia
pain and burning is common
C.T : immunofluorocense examination
treatment: nystatin sol 100.000u/ml 4times a day
amphotericin B suspension 100mg/ml 4 times a day
miconazole gel 2% 4*aday
new prosthetic device , rigorous oral hygiene
remove the prosthetic at nights
chronic atrophic candidiasis (prosthesis candidiasis)
LOCATED MAINLY ON THE HARD PALATE
HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia
pain and burning is common
C.T : immunofluorocense examination
treatment: nystatin sol 100.000u/ml 4times a day
amphotericin B suspension 100mg/ml 4 times a day
miconazole gel 2% 4*aday
new prosthetic device , rigorous oral hygiene
remove the prosthetic at nights
acute atrophic candidiasis
erythematous or stomatitis following antibiotic therapy
clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )
located mainly on the tongue and hard palate
{depapilation of the tongue is prsent }
C.T: direct microscopic examination , culture media
treatment: topical or systemic anti fungal therapy
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
hairy tongue
hairy tongue,
heredity, emotional stress, imunodeficiecy
its benign and its dekeratinization of the tongue
Usually the condition is located on the 2/3 dorsal and the lateral sides of the tongue
round ovale , erythematous border with white peripheral zone…….. more importantly it changes its appearance every 12-24 hours
no complementary test
treatmnt: just inform the patient that its a benign situation/ in caseof painful fissures use antifungal and topical steroids
hairy tongue,
heredity, emotional stress, imunodeficiecy
its benign and its dekeratinization of the tongue
Usually the condition is located on the 2/3 dorsal and the lateral sides of the tongue
round ovale , erythematous border with white peripheral zone…….. more importantly it changes its appearance every 12-24 hours
no complementary test
treatmnt: just inform the patient that its a benign situation/ in caseof painful fissures use antifungal and topical steroids
hairy tongue
keratin deposit on the tongue (appears in a hypertrophic form )
etiology:severe smoking candida albikans , low immune , poor hygine, long term use of antibiotics, metronidazol, systemic corticosteroids
clinicalaspect : hypertrophic lesion of the tongue in diff colors like white gray, yellow , brown it starts from foramen cecum of the tongue to lateral and anterir side of the tongue
no complementary test
treatment: nystatine if candida, palleteknife in moderate cases, brushing, keratolytic agents like salicilic acid
hairy tongue
hairy tongue,
heredity, emotional stress, imunodeficiecy
its benign and its dekeratinization of the tongue
Usually the condition is located on the 2/3 dorsal and the lateral sides of the tongue
round ovale , erythematous border with white peripheral zone…….. more importantly it changes its appearance every 12-24 hours
no complementary test
treatmnt: just inform the patient that its a benign situation/ in caseof painful fissures use antifungal and topical steroids
reticular lichen planus
reticularform of lichen planus
reticular lichen planus
most common tupe of planus
common location: jugal mucosa bilateral , but also on lips tongue , gingiva
clinical aspect: keratotic lesions called wicham straiae (so many)
C.test: histopathalogical test
immunofluorocense tet
treatment: assymptomatic lesion>>no treatment needed
symptomatic lesion>>>> systemic cyclosporine
reticular form of lichen planus
reticularform of lichen planus
reticular lichen planus
most common tupe of planus
common location: jugal mucosa bilateral , but also on lips tongue , gingiva
clinical aspect: keratotic lesions called wicham straiae (so many)
C.test: histopathalogical test
immunofluorocense tet
treatment: assymptomatic lesion>>no treatment needed
symptomatic lesion>>>> systemic cyclosporine
reticular form of lichnplanus
reticularform of lichen planus
reticular lichen planus
most common tupe of planus
common location: jugal mucosa bilateral , but also on lips tongue , gingiva
clinical aspect: keratotic lesions called wicham straiae (so many)
C.test: histopathalogical test
immunofluorocense tet
treatment: assymptomatic lesion>>no treatment needed
symptomatic lesion>>>> systemic cyclosporine
erosive form of lichenplanus
clinical aspect: burning and pain sensation more red than white compare to reticular form , erythematous lesion with some straia but the straia is not as white
retrocomissural (where mandible and maxila meet intraorally)
lower buccal vestibule(buccal mucosa) near the molar >>>> lower means mandible side
comlementary test: histo+ immunofluorosens
treatment
general:cyclosporine , nystatin in candida associated and cortico steroids cream and injection intra lesional
plaque form lichen planus
similar clinical aspect with leukoplakia,
the hyper-keratotic area can be neat or slightly harsh
. introduced retinoid treatment (Etretinate) with anti-keratinized
It is more frequently found on the dorsal part of the tongue and it usually expands in a centrifugal pattern
second jugal mucosa
complementary test : florocense , histopathalogocal
reticular lichen planus
reticularform of lichen planus
reticular lichen planus
most common tupe of planus
common location: jugal mucosa bilateral , but also on lips tongue , gingiva
clinical aspect: keratotic lesions called wicham straiae (so many)
C.test: histopathalogical test
immunofluorocense tet
treatment: assymptomatic lesion>>no treatment needed
symptomatic lesion>>>> systemic cyclosporine
reticular form of lichen planus
reticular lichen planus
reticularform of lichen planus
reticular lichen planus
most common tupe of planus
common location: jugal mucosa bilateral , but also on lips tongue , gingiva
clinical aspect: keratotic lesions called wicham straiae (so many)
C.test: histopathalogical test
immunofluorocense tet
treatment: assymptomatic lesion>>no treatment needed
symptomatic lesion>>>> systemic cyclosporine
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
acute atrophic candidiasis
erythematous or stomatitis following antibiotic therapy
clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )
located mainly on the tongue and hard palate
{depapilation of the tongue is prsent }
C.T: direct microscopic examination , culture media
treatment: topical or systemic anti fungal therapy
acute atrophic candidiasis
erythematous or stomatitis following antibiotic therapy
clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )
located mainly on the tongue and hard palate
{depapilation of the tongue is prsent }
C.T: direct microscopic examination , culture media
treatment: topical or systemic anti fungal therapy
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dysphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
major aphtous
Kaposi’s sarcoma
its an endothelial cells malignancy
4 types:1* classic kaposi’s sarcoma (skin lesion)
2*african kaposi’s sarcoma(skin lesions)
3*aquired kaposi’s sarcoma (skin)
4*EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation
lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.
located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva
C.T is biopsy
treatment: radiotherapy surgery, chemotherapy Co2 laser
Kaposi’s sarcoma
its an endothelial cells malignancy
4 types: classic kaposi’s sarcoma (skin lesion)
african kaposi’s sarcoma(skin lesions)
aquired kaposi’s sarcoma (skin)
EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation
lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.
located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva
C.T is biopsy
treatment: radiotherapy surgery, chemotherapy Co2 laser
Kaposi’s sarcoma
its an endothelial cells malignancy
4 types: classic kaposi’s sarcoma (skin lesion)
african kaposi’s sarcoma(skin lesions)
aquired kaposi’s sarcoma (skin)
EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation
lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.
located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva
C.T is biopsy
treatment: radiotherapy surgery, chemotherapy Co2 laser
Kaposi’s sarcoma
its an endothelial cells malignancy
4 types: classic kaposi’s sarcoma (skin lesion)
african kaposi’s sarcoma(skin lesions)
aquired kaposi’s sarcoma (skin)
EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation
lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.
located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva
C.T is biopsy
treatment: radiotherapy surgery, chemotherapy Co2 laser
Kaposi’s sarcoma
its an endothelial cells malignancy
4 types: classic kaposi’s sarcoma (skin lesion)
african kaposi’s sarcoma(skin lesions)
aquired kaposi’s sarcoma (skin)
EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation
lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.
located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva
C.T is biopsy
treatment: radiotherapy surgery, chemotherapy Co2 laser
Bullous lichen planus
bulla or vesicles can be from mm tocm
they will burst into painfull erosions located normally on the juggal mucosa near the wisdom tooth.
Reticular Striae are presents at the peripheral area of the lesion.
C.T histopathalogical
Treatment : no specific treatment
pigmented lichen planus lesions
pigmented papules with keratotic white lesions disposed in a reticular pattern.
C.T : histopathalogical
immunofluorescense can be useful
treatment: has no specific treatment
angular chelitis
angular chelitis
is a type of chronic candidiasis
bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts
C.T NO NEED
TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field
antifungal antibiotic therapy
angular chelitis
angular chelitis
is a type of chronic candidiasis
bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts
C.T NO NEED
TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field
antifungal antibiotic therapy
atrophic chronic candidiasis
chronic atrophic candidiasis (prosthesis candidiasis)
LOCATED MAINLY ON THE HARD PALATE
HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia
pain and burning is common
C.T : immunofluorocense examination
treatment: nystatin sol 100.000u/ml 4times a day
amphotericin B suspension 100mg/ml 4 times a day
miconazole gel 2% 4*aday
new prosthetic device , rigorous oral hygiene
remove the prosthetic at nights
acute atrophic candidiasis
acute atrophic candidiasis
erythematous or stomatitis following antibiotic therapy
clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )
located mainly on the tongue and hard palate
{depapilation of the tongue is prsent }
C.T: direct microscopic examination , culture media
treatment: topical or systemic anti fungal therapy
acute atrophic candida
acute atrophic candidiasis
erythematous or stomatitis following antibiotic therapy
clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )
located mainly on the tongue and hard palate
{depapilation of the tongue is prsent }
C.T: direct microscopic examination , culture media
treatment: topical or systemic anti fungal therapy
acute pseudomembranous candidiasis
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
ACUTE PSEUDOMEM CANDIDI
pseudomembranous candidiasis
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
pseudomem candid
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
acute pseudomembranous candidiasis
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
pseudomembranous candida
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
acute pseudomembranous candid
acute pseudomembranous candidiasis
in this situation the mouth is dry and burning with dyphagia
white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath
located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa
C.T: based on clinical examination and culture media on different media and direct microscopic examination
scarlet fever
cold seasons and children
General symptoms: shiver, vomiting, nausea, headache
fver, lymph adenopathy
two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days
2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .
complementary test : culture of type A streptococcus
treatment: antibiotics erythromycin , penicillin
scarlet fever
cold seasons and children
General symptoms: shiver, vomiting, nausea, headache
fver, lymph adenopathy
two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days
2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .
complementary test : culture of type A streptococcus
treatment: antibiotics erythromycin , penicillin
scarlet fever
cold seasons and children
General symptoms: shiver, vomiting, nausea, headache
fver, lymph adenopathy
two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days
2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .
complementary test : culture of type A streptococcus
treatment: antibiotics erythromycin , penicillin
scarlet fever
cold seasons and children
General symptoms: shiver, vomiting, nausea, headache
fver, lymph adenopathy
two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days
2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .
complementary test : culture of type A streptococcus
treatment: antibiotics erythromycin , penicillin
scarlet fever
cold seasons and children
General symptoms: shiver, vomiting, nausea, headache
fver, lymph adenopathy
two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days
2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .
complementary test : culture of type A streptococcus
treatment: antibiotics erythromycin , penicillin
scarlet fever
cold seasons and children
General symptoms: shiver, vomiting, nausea, headache
fver, lymph adenopathy
two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days
2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .
complementary test : culture of type A streptococcus
treatment: antibiotics erythromycin , penicillin
plummer-vinson Iron def anemia
angular chelitis can be present mostly
general signs: weight loss
pale face , dysponea , headache, hair and nail fragility
oral signs:burning sensation of the tongue, atrophy of filliform and fungiform papilla , dorsal surface of the tongue becomes red-glossy and smooth
*******
in case of plummer-vinson syndrom and hyperchromic anemia oral manifestations are accompanied by dysphagia caused by painful erosions of esophagus
C.T srium iron test
haemoglubin
hematocrit(low level)
treatment:m increasing the iron through supplements and real food
Iron def anemia
angular chelitis can be present mostly
general signs: weight loss
pale face , dysponea , headache, hair and nail fragility
oral signs:burning sensation of the tongue, atrophy of filliform and fungiform papilla , dorsal surface of the tongue becomes red-glossy and smooth
*******
in case of plummer-vinson syndrom and hyperchromic anemia oral manifestations are accompanied by dysphagia caused by painful erosions of esophagus
C.T srium iron test
haemoglubin
hematocrit(low level)
treatment:m increasing the iron through supplements and real food
Iron def anemia
angular chelitis can be present mostly
general signs: weight loss
pale face , dysponea , headache, hair and nail fragility
oral signs:burning sensation of the tongue, atrophy of filliform and fungiform papilla , dorsal surface of the tongue becomes red-glossy and smooth
*******
in case of plummer-vinson syndrom and hyperchromic anemia oral manifestations are accompanied by dysphagia caused by painful erosions of esophagus
C.T srium iron test
haemoglubin
hematocrit(low level)
treatment:m increasing the iron through supplements and real food
homogenous erythroplakia
red patches ,can be anywhere in the oral cavity ***common loc : tongue , soft palate, pillars, floor of the mouth
C.T: BIOPSY IS MANDATORY IN ALL CASES OF ERYTHROPLAKIA SINCE THEY HAVE A 90% POTENTIAL TOBECOME SQUAMOUS CELL CARCINOMA
HISTOPATHALOGICAL EXAMINATION
treatment : same principle as in the case of leukoplakia eliminate the irritating factor and monitor the lesion for 1-2 weeks then performing TOLUIDINE BLUE staining test.
pernicious anemia (fatal)
mostly happens on the tongue associated with pain,burning sensation , loss of taste, red glossy aspect and smooth depapillated <<hunter-glossitis>> aspect
the rst of the oral mucosa is pale.
C,T : haemoglubin and serum vit b12 test
myelogram (bone marrow)
erythrocytes
treatment:topical applications of benadryl or viscous xylocaine 2% rinse , several times a day
acute leukemia
clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy
C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation
treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.
thrombin sponges in case of gingival bleeding.
acute leukemia
clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy
C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation
treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.
thrombin sponges in case of gingival bleeding.
acute leukemia
clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy
C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation
treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.
thrombin sponges in case of gingival bleeding.
acute leukemia
clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy
C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation
treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.
thrombin sponges in case of gingival bleeding.
acute leukemia
clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy
C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation
treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.
thrombin sponges in case of gingival bleeding.
acute leukemia
clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy
C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation
treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.
thrombin sponges in case of gingival bleeding.
chronic leukemia
clinical: less severe than the acute form
pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia
leukemic nodules can be observed on the palatinenfiber-mucosa
C,T : peripheral blood analysis
medulograma>>>bone marrow analysis tosee if there is any leukemic cells
also send the patient to th haemotologist
treatment:like the acute one >>>>
send tohaemotologist
thrombin sponge in case of bleeding
chronic leukemia
clinical: less severe than the acute form
pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia
leukemic nodules can be observed on the palatinenfiber-mucosa
C,T : peripheral blood analysis
medulograma>>>bone marrow analysis tosee if there is any leukemic cells
also send the patient to th haemotologist
treatment:like the acute one >>>>
send tohaemotologist
thrombin sponge in case of bleeding
chronic leukemia
clinical: less severe than the acute form
pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia
leukemic nodules can be observed on the palatinenfiber-mucosa
C,T : peripheral blood analysis
medulograma>>>bone marrow analysis tosee if there is any leukemic cells
also send the patient to th haemotologist
treatment:like the acute one >>>>
send tohaemotologist
thrombin sponge in case of bleeding
chronic leukemia
clinical: less severe than the acute form
pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia
leukemic nodules can be observed on the palatinenfiber-mucosa
C,T : peripheral blood analysis
medulograma>>>bone marrow analysis tosee if there is any leukemic cells
also send the patient to th haemotologist
treatment:like the acute one >>>>
send tohaemotologist
thrombin sponge in case of bleeding
infectious mono neucleosis(kissing disease)
Epstain barr virus
transmitted through saliva
generally it has fever, pharyngitis , tonsilitis, lymh adenopathy, weakness , malaise
orally : petechiae (dark red dots ) in purpura is like rash or dark red bleeding dots
on the SOFT and HARD palate
can be associated with necrotsing acute gingivitis
diffused erythema of the oram mucosa
C,T test of specific antibodies
treatment: antiseptic adn topical anesthetic agents (supportive)
thrombocytopenic purpura
petechiae, ecchymoses and haematoma on the buccal mucosa and palate associated with spontanious bleeding from the gingiva
C.T: MYELOGRAM
PLATELET TEST
COAGULATION TIME
TREATMENT: systematic steroids
splenectomy
platelet transfusion
thrombocytopenic purpura
petechiae, ecchymoses and haematoma on the buccal mucosa and palate associated with spontanious bleeding from the gingiva
C.T: MYELOGRAM
PLATELET TEST
COAGULATION TIME
TREATMENT: systematic steroids
splenectomy
platelet transfusion