Podcast
Questions and Answers
Which treatment option is considered the most reliable for Major Aphthae?
Which treatment option is considered the most reliable for Major Aphthae?
Which symptom is most indicative of Behçet's Disease when considering its ocular complications?
Which symptom is most indicative of Behçet's Disease when considering its ocular complications?
What underlying condition may be associated with persistent Major Aphthae?
What underlying condition may be associated with persistent Major Aphthae?
Which of the following is a potential risk of Behçet's Disease?
Which of the following is a potential risk of Behçet's Disease?
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In managing Behçet's Disease, which approach is crucial due to the complexity of the condition?
In managing Behçet's Disease, which approach is crucial due to the complexity of the condition?
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What type of arthritis is typically associated with Behçet's Disease?
What type of arthritis is typically associated with Behçet's Disease?
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What is an emerging therapy that shows promise in the treatment of Behçet's Disease?
What is an emerging therapy that shows promise in the treatment of Behçet's Disease?
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Which characteristic is NOT associated with Major Aphthae?
Which characteristic is NOT associated with Major Aphthae?
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What is a key characteristic of dysplasia compared to hyperplasia?
What is a key characteristic of dysplasia compared to hyperplasia?
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Which treatment approach is fundamental for managing lichen planus?
Which treatment approach is fundamental for managing lichen planus?
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Which of the following is commonly associated with the use of topical steroids in lichen planus management?
Which of the following is commonly associated with the use of topical steroids in lichen planus management?
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In the context of vulvovaginal-gingival syndrome, what is a noted challenge in treatment?
In the context of vulvovaginal-gingival syndrome, what is a noted challenge in treatment?
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What complicates the risk assessment for malignant change in lichen planus?
What complicates the risk assessment for malignant change in lichen planus?
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Which of the following can trigger lichen planus-like lesions?
Which of the following can trigger lichen planus-like lesions?
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What is the primary approach to treating drug-induced lichenoid reactions?
What is the primary approach to treating drug-induced lichenoid reactions?
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How might lesions from restoration-induced reactions manifest?
How might lesions from restoration-induced reactions manifest?
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Which condition is NOT typically associated with self-harm behaviors?
Which condition is NOT typically associated with self-harm behaviors?
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What is the primary use of biopsy in the context of major aphthae?
What is the primary use of biopsy in the context of major aphthae?
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Which clinical feature distinguishes recurrent aphthous stomatitis from other ulcerative conditions?
Which clinical feature distinguishes recurrent aphthous stomatitis from other ulcerative conditions?
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What is a common management approach for recurrent aphthous stomatitis?
What is a common management approach for recurrent aphthous stomatitis?
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Which of the following is true regarding the prevalence of recurrent aphthous stomatitis?
Which of the following is true regarding the prevalence of recurrent aphthous stomatitis?
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What is a characteristic feature of oral lichen planus that can help differentiate it from other conditions?
What is a characteristic feature of oral lichen planus that can help differentiate it from other conditions?
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Which treatment is specifically noted for being effective against herpetiform aphthae?
Which treatment is specifically noted for being effective against herpetiform aphthae?
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What triggers flare-ups of lichen planus according to common observations?
What triggers flare-ups of lichen planus according to common observations?
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What characterizes the prodromal phase of recurrent aphthous stomatitis when a biopsy is performed?
What characterizes the prodromal phase of recurrent aphthous stomatitis when a biopsy is performed?
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What is the role of reassurance and education in managing recurrent aphthous stomatitis?
What is the role of reassurance and education in managing recurrent aphthous stomatitis?
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How do skin lesions associated with lichen planus typically present?
How do skin lesions associated with lichen planus typically present?
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During the active phase of lichen planus, what changes occur in the epithelium?
During the active phase of lichen planus, what changes occur in the epithelium?
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Which area is usually spared in oral lichen planus lesions?
Which area is usually spared in oral lichen planus lesions?
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What is the most common presentation of bullous lichen planus?
What is the most common presentation of bullous lichen planus?
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In what circumstance is a biopsy mandated for suspected lichen planus?
In what circumstance is a biopsy mandated for suspected lichen planus?
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What is a key differentiation between ulcerated lichen planus and other similar conditions?
What is a key differentiation between ulcerated lichen planus and other similar conditions?
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What is a significant feature of HIV-associated oral ulcers?
What is a significant feature of HIV-associated oral ulcers?
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What is the primary management strategy for ulcers induced by Nicorandil?
What is the primary management strategy for ulcers induced by Nicorandil?
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Which demographic is most likely to be affected by Lichen Planus?
Which demographic is most likely to be affected by Lichen Planus?
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What cellular mechanism is primarily involved in the pathology of Lichen Planus?
What cellular mechanism is primarily involved in the pathology of Lichen Planus?
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How does the prognosis for chronic conditions like Lichen Planus generally appear?
How does the prognosis for chronic conditions like Lichen Planus generally appear?
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What type of ulceration is commonly associated with Nicorandil usage?
What type of ulceration is commonly associated with Nicorandil usage?
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What is a characteristic feature of traumatic ulcers?
What is a characteristic feature of traumatic ulcers?
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Which statement accurately describes the healing characteristics of eosinophilic ulcers?
Which statement accurately describes the healing characteristics of eosinophilic ulcers?
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What percentage of the population is affected by Lichen Planus?
What percentage of the population is affected by Lichen Planus?
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What histological feature can be observed in conditions similar to Lichen Planus?
What histological feature can be observed in conditions similar to Lichen Planus?
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What is the common cause of factitious ulceration?
What is the common cause of factitious ulceration?
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In which locations do traumatic ulcers most commonly occur?
In which locations do traumatic ulcers most commonly occur?
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What distinguishes eosinophilic ulcers from other types of oral ulcers?
What distinguishes eosinophilic ulcers from other types of oral ulcers?
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What is the typical healing time for traumatic ulcers after removing the cause?
What is the typical healing time for traumatic ulcers after removing the cause?
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Which feature is NOT associated with recurrent oral ulcers?
Which feature is NOT associated with recurrent oral ulcers?
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What clinical feature might be observed in patients with factitious ulceration?
What clinical feature might be observed in patients with factitious ulceration?
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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.
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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.
