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Main causes of mouth ulcers (Systemic diseases (Mucocutaneous disease: …
Main causes of mouth ulcers
Drugs
Cytotoxic drugs (eg methotrexate), Alendronate (a bisphosphonate), Nicorandil, NSAIDs Many others.
Burn OR induction of lichenoid lesions.
Systemic diseases
Mucocutaneous disease:
Chronic ulcerative stomatitis
Epidermolysis bullosa
Sub-epithelial immune blistering diseases (Pemphigoid and variants, dermatitis herpetiformis, linear IgA disease)Behcet's syndrome
Pemphigoid:
Mucous membrane pemphigoid (MMP): Mucosal lesions predominate but skin lesions are rare
Oral mucosal pemphigoid: Oral lesions only, without ocular scarring process and bullous pemphigoid (BP)
Bullous pemphigoid (BP): Skin only
Ocular pemphigoid: Termed cicatricial pemphigoid (CP), causees serious conjunctival scarring.
Erythema Multiforme:
Major EM
Minor EM
Lichen Planus:
Papular LP — white papules
Reticular LP — a network of raised white lines or striae (reticular pattern)
Plaque-like LP — simulating leukoplakia * Atrophic red atrophic areas — simulating erythroplasia
Erosive erosions — less common, but persistent, irregular, and painful, with a yellowish slough
Behcet's Syndrome
Pemphigus:
Pemphigus vulgaris
Haematological disorders:
Anaemia
Gammopathies
Haematinic deficiencies
Leukaemia and myelodysplastic syndrome
Neutropenia and other white cell dyscrasias
Gastrointestinal disease:
Coeliac disease
Crohn's disease
Ulcerative colitis
Malignant disease
Oral
Encroaching from antrum
Local causes
Trauma:
Appliances
Iatrogenic
Non-accidental injury
Self Inflected
Sharp teeth or restorations
Burns:
Chemical
Cold
Electric
Heat
Radiationogenic
Recurrent aphthous stomatitis (RAS; aphthae; canker sores):
Starts in childhood or adolescence.
Presents with multiple recurrent small, round or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors.
Major aphthous ulcers (MjAU; Sutton’s Ulcers; periadenitis mucosa necrotica recurrens (PMNR))
Herpetiform Ulceration (HU)
Minor aphthous ulcers (MiAU; Mikulicz Ulcer)
Infections
Acute necrotising gingivitis
Chickenpox
Deep mycoses
Hand, foot and mouth disease
Herpangina
Herpetic stomatitis
HIV
Infectious mononucleosis
Syphilis
Tuberculosis
HSV-1: Above the belt + Young patient
HSV-2: Below the belt + Adolescence and adults