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15 Cards in this Set

  • Front
  • Back
Reccurent Apthous Ulcerations
- Common; familial relationship
- Unknown pathogenesis; immune-mediated process
- Most common in children and young adults
- Possible "triggers'- stress, local trauma, menstration
Minor Apthous Ulcerations
- 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
Major Apthous Ulcerations
- 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
Herpetiform Apthous Ulcerations
- 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
Recurrent Apthous Ulcerations
- 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
Behcet's Syndrome
- 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
Behcet's Syndrome- Oral Involvement
- 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
Behcet's Syndrome- Genital Involvement
- Similar to oral ulcerations
- Occur in 75% cases
Behcet's Syndrome- Ocular Involvement
- Occur 75-85% cases
- Posterior uvetitis (conjunctivitis, corneal ulceration, arteritis, etc)
Behcet's Syndrome Tx and Dx
- 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
Orofacial Granulomatosis
- 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
Melkersson-Rosenthal Syndrome
- Non-tender lip swelling
- Bell's Palsy
- Fissured tongue
Cheilitis Granulomatosa
Involvement of the lips alone
Oralfacial Granulomatosis- Microscopic Features
- 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
Oralfacial Granulomatosis- Tx and Prognosis
- Pts require thorough medical evaluation
- Remove sources of inflammation
- Intralesional corticosteroids work best
- Multiple injections may be necessary
- Good prognosis; primarily a cosmetic problem