Non-Infective Stomatitis Overview
48 Questions
3 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which treatment option is considered the most reliable for Major Aphthae?

  • Cyclosporin
  • Azathioprine
  • Colchicine
  • Thalidomide (correct)

Which symptom is most indicative of Behçet's Disease when considering its ocular complications?

  • Erythema nodosum
  • Leukoplakia
  • Retinal artery thrombosis (correct)
  • Mucosal lesions

What underlying condition may be associated with persistent Major Aphthae?

  • Irritable Bowel Syndrome
  • HIV infection (correct)
  • Hypertension
  • Diabetes Mellitus

Which of the following is a potential risk of Behçet's Disease?

<p>Blindness (C)</p> Signup and view all the answers

In managing Behçet's Disease, which approach is crucial due to the complexity of the condition?

<p>Multidisciplinary team approach (C)</p> Signup and view all the answers

What type of arthritis is typically associated with Behçet's Disease?

<p>Relapsing or constant pain without destruction (C)</p> Signup and view all the answers

What is an emerging therapy that shows promise in the treatment of Behçet's Disease?

<p>Anti-TNFα drugs (A)</p> Signup and view all the answers

Which characteristic is NOT associated with Major Aphthae?

<p>Causes joint deformities (B)</p> Signup and view all the answers

What is a key characteristic of dysplasia compared to hyperplasia?

<p>Dysplasia involves abnormal precancerous cell growth. (C)</p> Signup and view all the answers

Which treatment approach is fundamental for managing lichen planus?

<p>Oral hygiene (A)</p> Signup and view all the answers

Which of the following is commonly associated with the use of topical steroids in lichen planus management?

<p>Candidal infections (A)</p> Signup and view all the answers

In the context of vulvovaginal-gingival syndrome, what is a noted challenge in treatment?

<p>It often leads to significant complications. (D)</p> Signup and view all the answers

What complicates the risk assessment for malignant change in lichen planus?

<p>Dysplastic lesions that closely resemble benign lesions. (D)</p> Signup and view all the answers

Which of the following can trigger lichen planus-like lesions?

<p>Known drugs (D)</p> Signup and view all the answers

What is the primary approach to treating drug-induced lichenoid reactions?

<p>Withdraw the offending drug (C)</p> Signup and view all the answers

How might lesions from restoration-induced reactions manifest?

<p>They are localized to areas in contact with restorations. (C)</p> Signup and view all the answers

Which condition is NOT typically associated with self-harm behaviors?

<p>Recurrent aphthous stomatitis (C)</p> Signup and view all the answers

What is the primary use of biopsy in the context of major aphthae?

<p>To exclude carcinoma or viral infection (C)</p> Signup and view all the answers

Which clinical feature distinguishes recurrent aphthous stomatitis from other ulcerative conditions?

<p>Aphthae not being preceded by vesicles (A)</p> Signup and view all the answers

What is a common management approach for recurrent aphthous stomatitis?

<p>Corticosteroids to reduce inflammation (A)</p> Signup and view all the answers

Which of the following is true regarding the prevalence of recurrent aphthous stomatitis?

<p>It is the most common oral mucosal disease affecting up to 25% (A)</p> Signup and view all the answers

What is a characteristic feature of oral lichen planus that can help differentiate it from other conditions?

<p>Meshwork of fine, snowy white keratinized lines (A)</p> Signup and view all the answers

Which treatment is specifically noted for being effective against herpetiform aphthae?

<p>Tetracycline mouth rinses (C)</p> Signup and view all the answers

What triggers flare-ups of lichen planus according to common observations?

<p>Stress and trauma (B)</p> Signup and view all the answers

What characterizes the prodromal phase of recurrent aphthous stomatitis when a biopsy is performed?

<p>Lymphocytic infiltration of the epithelium is observed (C)</p> Signup and view all the answers

What is the role of reassurance and education in managing recurrent aphthous stomatitis?

<p>To reassure about the benign nature of the condition (B)</p> Signup and view all the answers

How do skin lesions associated with lichen planus typically present?

<p>Purplish papules with itching (B)</p> Signup and view all the answers

During the active phase of lichen planus, what changes occur in the epithelium?

<p>Atrophy and ulceration of the epithelium (A)</p> Signup and view all the answers

Which area is usually spared in oral lichen planus lesions?

<p>Floor of the mouth (D)</p> Signup and view all the answers

What is the most common presentation of bullous lichen planus?

<p>Blisters on the gingiva that rupture quickly (C)</p> Signup and view all the answers

In what circumstance is a biopsy mandated for suspected lichen planus?

<p>When lesions appear atypical or plaque-like (C)</p> Signup and view all the answers

What is a key differentiation between ulcerated lichen planus and other similar conditions?

<p>Ulcerated lichen planus shows basal cell destruction (A)</p> Signup and view all the answers

What is a significant feature of HIV-associated oral ulcers?

<p>Severe recurrent aphthae resembling common aphthae (A)</p> Signup and view all the answers

What is the primary management strategy for ulcers induced by Nicorandil?

<p>Withdrawal of the drug (A)</p> Signup and view all the answers

Which demographic is most likely to be affected by Lichen Planus?

<p>Middle-aged or older individuals, slightly more frequent in females (A)</p> Signup and view all the answers

What cellular mechanism is primarily involved in the pathology of Lichen Planus?

<p>Cytotoxic T cell infiltration leading to apoptosis of basal cells (C)</p> Signup and view all the answers

How does the prognosis for chronic conditions like Lichen Planus generally appear?

<p>Relapses may occur but could become less frequent over time (C)</p> Signup and view all the answers

What type of ulceration is commonly associated with Nicorandil usage?

<p>Painful, sharply demarcated ulcers on the tongue and buccal mucosa (D)</p> Signup and view all the answers

What is a characteristic feature of traumatic ulcers?

<p>They may have a yellowish-grey fibrin slough. (A)</p> Signup and view all the answers

Which statement accurately describes the healing characteristics of eosinophilic ulcers?

<p>Biopsy can accelerate the healing process. (B)</p> Signup and view all the answers

What percentage of the population is affected by Lichen Planus?

<p>1% - 2% (B)</p> Signup and view all the answers

What histological feature can be observed in conditions similar to Lichen Planus?

<p>Destruction of the basement membrane (D)</p> Signup and view all the answers

What is the common cause of factitious ulceration?

<p>Self-inflicted trauma related to psychosocial disorders. (D)</p> Signup and view all the answers

In which locations do traumatic ulcers most commonly occur?

<p>Lips and adjacent to denture flanges. (B)</p> Signup and view all the answers

What distinguishes eosinophilic ulcers from other types of oral ulcers?

<p>They typically measure more than 10 mm in diameter. (A)</p> Signup and view all the answers

What is the typical healing time for traumatic ulcers after removing the cause?

<p>Within a few days to 2 weeks. (D)</p> Signup and view all the answers

Which feature is NOT associated with recurrent oral ulcers?

<p>They always produce pus. (A)</p> Signup and view all the answers

What clinical feature might be observed in patients with factitious ulceration?

<p>Non-healing ulcers in the anterior mouth. (C)</p> Signup and view all the answers

Flashcards

Oral Ulcer

An open sore in the skin or mucous membrane with tissue loss and often pus.

Recurrent Oral Ulcers

Oral ulcers that repeatedly appear in the same or different locations.

Traumatic Ulcers

Ulcers caused by biting, dentures, or chemicals, often healing when the cause is removed.

Eosinophilic Ulcer

An uncommon ulcer caused by an overreaction to trauma, often resembling carcinoma.

Signup and view all the flashcards

Factitious Ulceration

Ulcers caused by self-inflicted trauma, often linked to mental health issues.

Signup and view all the flashcards

Riga-Fede Disease

A specific type of Eosinophilic Ulcer in infants, caused by erupting teeth.

Signup and view all the flashcards

Features of Eosinophilic Ulcers

Ulcers that persist for several weeks and are often associated with inflammation.

Signup and view all the flashcards

Factitious Ulceration and Mental Health

Factitious Ulceration is often linked to mental health issues, as patients may gain a perceived benefit.

Signup and view all the flashcards

Major Aphthae

Painful, persistent, and resistant to conventional treatment oral ulcers. May be associated with underlying diseases like HIV infection.

Signup and view all the flashcards

Behçet's Disease (Behçet's Syndrome)

A rare disorder causing systemic blood vessel inflammation leading to symptoms like oral sores, genital ulcers, eye inflammation, and skin lesions. Can cause life-threatening complications like thrombosis, blindness, or brain damage.

Signup and view all the flashcards

Mucocutaneous Behçet's

Oral ulcers resembling common aphthous stomatitis, genital ulcers, and skin rashes.

Signup and view all the flashcards

Arthritic Behçet's

Involves large weight-bearing joints, causing relapsing or constant pain but no destructive arthritis.

Signup and view all the flashcards

Neurological Behçet's

Late-stage vasculitis in the brain causing sensory/motor issues, confusion, fits, or thrombosis.

Signup and view all the flashcards

Ocular Behçet's

Uveal inflammation, vasculitis, or retinal artery thrombosis, potentially leading to blindness if untreated.

Signup and view all the flashcards

Immune-mediated reaction in Behçet's

Circulating immune complexes, high cytokine levels, and lymphocyte/macrophage activation suggest immune involvement. Possibly triggered by an unknown infectious agent via immune cross-reaction with host heat shock proteins.

Signup and view all the flashcards

Genetic Factors in Behçet's

Strongly associated with HLA-B51, a genetic marker predicting ocular lesions.

Signup and view all the flashcards

Recurrent Aphthous Stomatitis (RAS)

The most common oral mucosal disease, affecting up to 25% of the population.

Signup and view all the flashcards

Severity of RAS

Many cases are mild and go untreated.

Signup and view all the flashcards

Clinical Presentations of RAS

RAS presents in three distinct forms: minor aphthae, major aphthae, and herpetiform aphthae.

Signup and view all the flashcards

Differentiation from other conditions

Lesions similar to RAS can appear in other diseases, but their true classification as RAS remains uncertain.

Signup and view all the flashcards

Role of Biopsy in RAS diagnosis

Biopsy is not typically used for diagnosis of RAS. It's only performed to rule out carcinoma or viral infection.

Signup and view all the flashcards

Findings of Biopsy in RAS

A biopsy of RAS shows lymphocytic infiltration of the epithelium followed by epithelial destruction with inflammation.

Signup and view all the flashcards

Clinical Feature of RAS

Aphthae are not preceded by vesicles, setting them apart from viral lesions.

Signup and view all the flashcards

Management of RAS

Reassurance and education are essential for patients with RAS.

Signup and view all the flashcards

Lichen Planus

A condition where the body's immune system mistakenly attacks its own tissues, causing inflammation and damage. It affects the skin and mucous membranes, causing white, lacy patches, red, swollen tissues, and painful open sores.

Signup and view all the flashcards

Lichenoid Processes

A group of conditions that resemble lichen planus in appearance or microscopic features.

Signup and view all the flashcards

HIV-Associated Oral Ulcers

Severe, often recurring mouth sores that look like regular aphthous ulcers but are more severe and persistent.

Signup and view all the flashcards

Nicorandil-Induced Ulcers

Painful sores that appear on the tongue, cheeks, gums, or throat due to using the heart medication nicorandil.

Signup and view all the flashcards

Cytotoxic T Cells (CD8+)

A type of immune cell that destroys infected cells by releasing toxic substances (perforin) and signaling molecules (TNFα).

Signup and view all the flashcards

Apoptosis

A process in which a cell dies prematurely due to internal or external signals, leading to cell death.

Signup and view all the flashcards

Topical Steroids

A type of medication that reduces inflammation and swelling, often used to treat mouth sores.

Signup and view all the flashcards

Antiretroviral Therapy

Treatment that uses antiretroviral drugs to suppress the HIV virus, which in turn reduces the severity and frequency of HIV-associated mouth sores.

Signup and view all the flashcards

Wickham's striae

Whitish, keratotic lines that appear on the oral mucosa, commonly seen in lichen planus.

Signup and view all the flashcards

Skin lesions in lichen planus

Small, purplish bumps (papules) on the skin, often found on the forearms and wrists, associated with lichen planus.

Signup and view all the flashcards

Reticular oral lichen planus

A common phase of lichen planus characterized by fine, white lines (striae) forming a lacy pattern on the oral mucosa.

Signup and view all the flashcards

Atrophic oral lichen planus

A phase of oral lichen planus characterized by thin, red areas on the oral mucosa with visible inflammation.

Signup and view all the flashcards

Ulcerated oral lichen planus

A severe form of oral lichen planus characterized by deep, irregular sores on the oral mucosa, often covered with a yellowish layer.

Signup and view all the flashcards

Bullous oral lichen planus

A type of oral lichen planus characterized by fluid-filled blisters (bullae) forming on the gums, often rupturing into sores.

Signup and view all the flashcards

Biopsy for oral lichen planus

To diagnose oral lichen planus, a biopsy is essential in cases of white lesions to rule out dysplasia (abnormal cell growth).

Signup and view all the flashcards

Dysplasia

Abnormal precancerous cell growth, more severe than hyperplasia (overgrowth of normal cells).

Signup and view all the flashcards

Oral Hygiene

Essential for managing lichen planus, helps prevent infections and maintain oral health.

Signup and view all the flashcards

Vulvovaginal-Gingival Syndrome

A rare but serious form of lichen planus affecting the vulva, vagina, and gums, with potential for scarring and difficulties in treatment.

Signup and view all the flashcards

Candidal Infections

A potential complication of lichen planus, often resulting from keratinization and steroid use; requires antifungal treatment.

Signup and view all the flashcards

Malignant Change in Lichen Planus

Though rare, there's a risk of developing oral squamous carcinoma from lichen planus.

Signup and view all the flashcards

Lichenoid Reactions

Lichen planus-like lesions triggered by known factors, often drugs, causing skin or mucosal reactions that may persist after drug withdrawal.

Signup and view all the flashcards

Restoration-induced Reactions

Lichenoid reactions caused by amalgam restorations, particularly corroded ones, leading to localized mucosal lesions that heal after restoration removal.

Signup and view all the flashcards

Study Notes

Non-Infective Stomatitis

  • Ulcers: Breaks in skin/mucous membranes, often with pus. Most heal in a few days to two weeks. Recurrent ulcers occur at the same or different sites.

Traumatic Ulcers

  • Causes: Biting, dentures, chemical irritants (e.g., dental etchants).
  • Locations: Lips, buccal mucosa, areas near dentures.
  • Features: Tender, yellowish-grey fibrin slough with red margins. No induration unless scarred. May follow dental anesthesia. Typically heal within days after removing cause. Biopsy recommended if persisting >10 days without improvement.

Eosinophilic Ulcer (Atypical or Traumatic Eosinophilic Granuloma)

  • Presentation: Deep ulcer or mass (>10mm), enlarging before stabilizing.
  • Causes: Likely unusual reaction to trauma, though trauma history may not always be present.
  • Locations: Tongue, gingiva, rarely other areas.
  • Special Cases: Riga-Fede disease in infants (lower incisors traumatizing tongue).
  • Features: May persist for months, raising above mucosa due to inflammatory infiltrate. Histologically can resemble lymphoma. Typically resolves spontaneously in 3-10 weeks. Biopsy often accelerates healing.

Factitious Ulceration (Self-Inflicted Oral Ulcers)

  • Features: Intentional self-inflicted ulcers, often linked with psychosocial disorders where patients gain a perceived benefit.
  • Locations: Commonly in the anterior mouth.
  • Causes: Diverse methods, including severe self-injury like tooth extraction. Often associated with underlying emotional disturbances.

Recurrent Aphthous Stomatitis (RAS)

  • Prevalence: Most common oral mucosal disease, affecting up to 25% of population.
  • Severity: Many cases are mild, most often go untreated.
  • Presentations: Three clinical forms defined by presentations (minor, major, herpetiform).
  • Differentiation: Ulcers resembling RAS can occur in other disorders and differentiating as true RAS can be uncertain.

Major Aphthae

  • Characteristics: Painful, persistent, resistant to conventional treatment; can be disabling.
  • May Be Associated With: Underlying diseases like HIV.

Behçet's Disease (Behçet's Syndrome)

  • Definition: Rare disorder causing systemic blood vessel inflammation. Leads to oral sores, genital ulcers, eye inflammation, and skin lesions. Can cause serious complications.
  • Clinical Features: Affects mostly young adult males (20-40 years old).
  • Patterns of Disease: Mucocutaneous, Arthritic, Neurological and Ocular.

HIV-Associated Oral Ulcers

  • Features: Often major or herpetiform, resembling common aphthae.
  • Diagnosis: Requires biopsy for non-healing ulcers to rule out opportunistic infections.

Nicorandil-Induced Ulcers

  • Cause: Potassium channel activator drug used in angina treatment, often on lateral tongue, buccal mucosa and gingiva.
  • Features: Painful, sharply demarcated ulcers, sometimes on the perianal or vulval skin, may occur a few weeks to 18 months after starting the drug or more frequent at higher doses.

Lichen Planus

  • Prevalence: Affects 1%–2% of the population
  • Demographics: Common in middle-aged or older individuals, slightly more frequent in females.
  • Type: Chronic inflammatory disease of the skin and mucous membranes.
  • Aetiology and Pathogenesis: Unknown cause; multiple factors may play a role; cytotoxic and helper T cells infiltrate and destroy basal cells, causing thinning, keratinization, or ulceration of the epithelium; basement membrane damage.
  • Clinical Features: Oral lesions are often white, keratotic lines (Wickham's striae) that are common on the mucosa. Might have other features such as itchy purplish 2-3mm papules on forearms, wrists (skin lesions)
  • Course of Disease: Flare-ups triggered by stress, trauma, or dental treatment.

Vulvovaginal-Gingival Syndrome

  • Type: Severe but uncommon form of lichen planus involving genital mucosa and gingiva. Involves buccal mucosa, tongue, scalp, esophagus, and eyes, commonly.
  • Features: Leads to significant complications, resistant to treatment, requires high-potency steroids often.

Malignant Change in Lichen Planus

  • Rarity: Rare but possible risk of developing oral squamous carcinoma.
  • Challenges: Non-specific clinical and histological features, making early detection of dysplasia difficult.
  • Distinguishing Feature: Plaque-type lichen planus can resemble leukoplakia.

Lupus Erythematosus (LE)

  • Features: Autoimmune connective tissue disease; oral lesions resemble lichen planus but with less defined striae; unilateral lesions, symmetrical ulcers with erythema, radiating striae, and palatal involvement are common features.

Chronic Ulcerative Stomatitis (CUS)

  • Rarity: Rare mucosal disease,
  • Demographics: Primarily affects females over 40 years.
  • Clinical Features: Shallow ulcers, erosions, or erythema, most commonly affecting the tongue, followed by buccal mucosa and gingiva.
  • Diagnosis: Suspect in patients with severe, steroid-resistant lichen planus-like lesions, requires immunofluorescence or ELISA to confirm.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Ch16 Part 1: Non-Infective Stomatitis PDF

Description

This quiz covers the types and characteristics of non-infective stomatitis, including traumatic ulcers and eosinophilic ulcers. Learn about the causes, features, and healing processes of these conditions. Test your knowledge on clinical presentations and management strategies.

More Like This

Use Quizgecko on...
Browser
Open
Browser
Browser