stomatitis (includes oral ulceration)
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Introduction
Inflammation of the mucous membranes of the mouth, generally ulcerative or vesicular.
Etiology
- unknown: aphthous stomatitis
- viral infection
- bacterial infection
- systemic disorder
- trauma
- biting
- ill-fitting dentures
- defective tooth fillings
- irritants
- chemotherapy
- carcinoma 96% oral ulcerations are squamous cell carcinoma
Clinical manifestations
- general
- oral vesicles or ulcers
- oral pain
- systemic symptoms
- lymphadenopathy
- specific signs/symptoms for specific etiologies
Laboratory
- acute & convalescent serology for HSV-1
- cytology showing giant cells with viral inclusion bodies
- darkfield microscopy for syphilis
- biopsy for suspected tuberculosis, fungi, carcinoma
- diagnosis of aphthous stomatitis is clinical
Differential diagnosis
- allergic reaction
- lesions tend to be diffuse
- do not ulcerate
- various etiologies of stomatitis
Management
- palliative treatment for aphthous stomatitis
- antibacterial mouthwash
- tetracycline
- chlorhexidine gluconate oral rinse (Peridex)
- acyclovir for Herpes
- topical for Herpes labialis
- systemic acyclovir for prodrome/gingivostomatitis
- biopsy any ulcer that fails to heal
More general terms
More specific terms
- angular stomatitis
- aphthous stomatitis; aphthous ulcer (canker sore)
- gingivostomatitis
- hand-foot-&-mouth disease
- herpangina
- Herpes simplex labialis (cold sore)
- pyostomatitis vegetans
- uvulitis
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 3017-18
- ↑ 2.0 2.1 Unizony SH, Kim ND, Hoang MP. Case Records of the Mass General Hospital. Case 7-2015: A 25-year-old man with oral ulcers, rash, and odynophagia. N Engl J Med. 2015 Feb 26;372(9):864-72 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25714165 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1413303