Ulcers and infection
This is an irregular ulcer with indurated base and undermined edge and the dorsum of the tongue is the most common site
Tuberculosis ulcer
What disease is usually present in children? *herpetic diseases only
ACUTE HERPETIC GINGIVOSTOMATITIS (AHGS)
What type of virus is coxsackie?
RNA virus
What is the most common reccurent ulcer?
Recurrent Aphthous Ulcer
Enumerate the lesions that heal with scar formation
Heal with scar formation:
• Herpes zoster
• Mucous Membrane Pemphigoid
• Major Recurrent Aphthous Ulcers
Which stage of syphillis can be treated with penicillin?
Chancre (primary stage)
Which lymph nodes does ACUTE HERPETIC GINGIVOSTOMATITIS affect? (Lymphadenopathy of the....)
submandibular and upper deep cervical lymph nodes
Treatment of any disease caused by coxsackie?
No treatment is required
Topical anesthesia and mouth wash are used in severe cases
What are the etiological factors for RAU?
Hereditary, immunologic, hematologic, trauma, psychologic stress, anxiety, allergy to foods and hormonal disturbances.
• Chancre
• Major recurrent aphthous ulcer
• Long standing traumatic ulcer
• Tuberculosis
What is the primary site of inoculation and the primary site of infection of syphillitic chancre?
Isolation of HSV in tissue culture of ACUTE HERPETIC GINGIVOSTOMATITIS (AHGS)
What is the chief complaint of someone with macules, papules and vesicles on skin of hands and feet and infection with coxsackie virus?
Sore mouth and refusal to eat
What is the etiology of the recurrent form of herpes labialis and how can we differenciate it from primary form?
reactivation of the Latent virus
+
High antibody titer
NO systemic Prodromal features
There are 5 diseases that come with eye involvement. List them.
Associated with eye lesions:
• EM
• Herpes zoster
• MMP
• Behcet’s syndrome
• Reiter’s syndrome
Describe the expected clinical picture of tertiary syphillis.
affects the hard palate causing Gumma which destroys the palatal bone, resulting in palatal perforation and/or the tongue resulting in single, deep ulcer with u-punched out margins
What are the manifestations of herpes zoster virus when it affects the Mandibular division?
unilateral lesions in buccal mucosa, Tongue, Vestibule of the lower jaw, Skin lesions extending from the chin to the vertex.
Which types of erythema multiform are accompanied with systemic manifestations as fever and malaise?
Stevens Johnson syndrome, and toxic epidermal necrolysis (TEN)
Which disease caused the highest incidence in Asia and the Mediterranean of blindness in young men?
Behcet’s syndrome
Describe the depth of ulcers that come with chemotherapy and their characteristic smell
Deep with a foul smell.
What are the clinical features of viral infections?
Prodrome
Vesicle formation.
Ulcers: small, shallow, rounded and surrounded by erythema (red halo).
Pain
Increased salivation.
Self-limiting disease, heal with or without scar formation without treatment.
What is the clinical picture of RECURRENT INTRAORAL HERPES?
Vesicles on the keratinized mucosa (tongue, hard palate and gingiva) that may occur in clusters.
Vesicles rupture forming multiple (dozens) ulcers which are pin-head size and surrounded by erythema. Ulcers tend to coalesce forming larger ulcers which appear irregular, superficial, surrounded by erythema and extremely painful.
Ulcers heal without scar formation in 7 – 14 days.
EM must be differentiated from AHGS since steroids used in the treatment of EM are contraindicated in AHGS. How can we differentiate them?
AHGS ulcers are small, shallow, round and affect both keratinized and non-keratinized oral mucosa and generalized gingival involvement is characteristic.
EM ulcers are large, irregular, deeper, and often bleed and ulcers may occur anywhere on the oral mucosa mainly the lips (bloody crusted lips) and the gingival involvement is rare.
Disease characterized by arthritis, urethritis, conjunctivitis together with oral aphthous like ulcers
Reiter’s syndrome
Which ulcer is characterized by these properties:
Shallow with bleeding.
Deep
Not surrounded by a red halo
has peripheral extension
Pemphigus vulgaris