ulceration

Question 1

what is ulceration

Answer 1

localised defect where there is destruction of epithelium exposing the underlying connective tissue

Question 2

Name 4 causes of ulceration

Answer 2

trauma, allergy, infection, neoplastic, idiopathic, nutritional deficiencies

Question 3

vesicle vs blister

Answer 3

vesicle - small fluid filled lump
blister - larger fluid filled lump

Question 4

describe the appearance of a typical traumatic ulcer

Answer 4

connective tissue in centre (yellow) with keratinised gingiva border (white)
normally surrounding mucosa is normal and ulcer is soft

Question 5

describe the appearance of a typical aphthous ulcer

Answer 5

painful red border with yelow/ white centre

Question 6

What tests would be required if investigating RAU

Answer 6

FBC, vit B12, folate, ferritin and coeliac screen

Question 7

Behcets disease

Answer 7

rare condition that causes blood vessel inflammation throughout the body. Almost all will have mouth ulcers

Question 8

what are the 3 different types/classes of recurrrent aphthous stomatitis

Answer 8

major
minor
herpetiform

Question 9

herpetiform RAS

Answer 9

characterised by multiple small ulcers that may coalesce

Question 10

major RAS

Answer 10

characterised by ulcers greater than 1cm which take a long time to heal

Question 10

minor RAS

Answer 10

characterised by ulcers less than 1cm that heal within 2-3 weeks

Question 11

what type of gingiva do RAS ulcers usually appear

Answer 11

non - keratinised

Question 12

necrotising sialometaplasia

Answer 12

rare condition seeing necrosis of minor salivary gland, typically seen on the palate and in smokers

Question 13

describe the ‘moveability’ of neoplastic ulcers vs aphthous ulcers

Answer 13

neoplastic are non moveable (n=n), if try and move tongue ulcer, whole tongue will move
Aphthous ulcers are moveable as the only affect the epithelium

Question 14

recurrent self healing ulcer on non keratinised mucosa - most likely diagnosis?

Answer 14

recurrent aphthous ulceration

Question 15

recurring ulcers affecting keratinised mucosa - most likely cause?

Answer 15

viral infections

Question 16

what virus causes hand foot and mouth disease

Answer 16

coxsackie virus

Question 17

most common age to get hand foot and mouth disease (coxsackie virus)

Answer 17

5-7 years old

Question 18

where are ulcers found in mouth during coxsackie virus infection

Answer 18

throat, hard and soft palate = most common
also tongue, cheeks, gingivae

Question 19

describe the characteristic Crohn’s ulcer

Answer 19

linear fissue ulcers along depth of sulcus, last for months

Question 20

what two types of ulcers might be seen simultaneously in a Crohn’s patient mouth

Answer 20

linear fissue ulcer, assosciated with the disease
Oval aphthous ulcers - due to haematinic deficiencies

Question 21

diagnosis of behcets disease

Answer 21

recurrent oral ulceration >=3 times in 12 months
plus at least 2 of…
- eye inflammation
- recurrent genital ulceration
- skin ulcers
- pathergy (exaggerated response to trauma)