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15 Cards in this Set
- Front
- Back
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Reccurent Apthous Ulcerations
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- Common; familial relationship
- Unknown pathogenesis; immune-mediated process - Most common in children and young adults - Possible "triggers'- stress, local trauma, menstration |
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Minor Apthous Ulcerations
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- 1-5 painful ulcers; preceded by erythematous macule w/ prodromal symptoms
- Round to oval ulcer; 3-10 mm diameter - Erythematous halo - Heal w/o scarring 7-10 days - Rate of recurrence highly variable |
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Major Apthous Ulcerations
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- Larger than minor apthae; 1-3 cm diameter
- Longer duration per episode; heal in 2-6 weeks often w/ scarring - 1-10 lesions per episode - Most common sites: labial mucosa, soft palate, tonsillar fauces |
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Herpetiform Apthous Ulcerations
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- Greatest number of lesions and most frequent recurrences
- Individual lesions small (1-3mm), w/ many present per episode - Any oral mucosal surface - Superficial resemblance to primary HSA= "herpetiform" - Heal in 7-10 days, but recurrences tend to be closely spaced |
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Recurrent Apthous Ulcerations
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- Dx: based on clinical presentation; histopathology non-specific
- Tx: respond well topical high-potency corticosteroids (Betamethasone); applied eraly in course of disease; thin film, multiple times per day |
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Behcet's Syndrome
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- Multisystem disorder w/ oral apthous-like ulcerations
- Highest prevelance in Middle East and Japan - Classic Triad: oral ulcerations, genital ulcerations, ocular disease - Cutaneous lesions, arthritis, CNS involvement, cardiovascular, GI, muscular, pulmonary, renal, ect |
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Behcet's Syndrome- Oral Involvement
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- Similar to apthous ulcers
- 1st manifestation in up to 75% cases - Occur in 99% cases - Commonly involves soft palate and oropharynx - Variable size, ragged borders, large zone erythema |
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Behcet's Syndrome- Genital Involvement
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- Similar to oral ulcerations
- Occur in 75% cases |
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Behcet's Syndrome- Ocular Involvement
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- Occur 75-85% cases
- Posterior uvetitis (conjunctivitis, corneal ulceration, arteritis, etc) |
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Behcet's Syndrome Tx and Dx
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- Dx: Based on clinical presentations; positive pathergy test
- Tx: Topicacl or systemic immunosuppressive or immunomodulatory therapy; early aggressive therapy for severe cases - Prognosis: generally good; relapsing/remitting course |
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Orofacial Granulomatosis
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- Unknown etiology; appears to represent an abnormal immune reaction
- Non-necrotizing granulomatous inflammation, presenting as persistent non-tender swelling - Most often in adults - Lips most common site |
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Melkersson-Rosenthal Syndrome
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- Non-tender lip swelling
- Bell's Palsy - Fissured tongue |
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Cheilitis Granulomatosa
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Involvement of the lips alone
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Oralfacial Granulomatosis- Microscopic Features
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- SUperficial vascular ectasia, vasculitis, edema
- Non-necrotizing granulomas; but these may be sparse - No evidence of foreign material and special stains to rule out specific infections |
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Oralfacial Granulomatosis- Tx and Prognosis
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- Pts require thorough medical evaluation
- Remove sources of inflammation - Intralesional corticosteroids work best - Multiple injections may be necessary - Good prognosis; primarily a cosmetic problem |
