Stomatitis

Stomatitis Microchapters
Home
Patient Information
Overview
Historical perspective
Classification
Pathophysiology
Causes
Differentiating Stomatitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Stomatitis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Stomatitis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Stomatitis
CDC on Stomatitis
Stomatitis in the news
Blogs on Stomatitis
Directions to Hospitals Treating Bursitis
Risk calculators and risk factors for Stomatitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Stomatitis is an inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, throat, and roof or floor of the mouth. The inflammation can be caused by conditions in the mouth itself, such as poor oral hygiene, poorly fitted dentures, or from mouth burns from hot food or drinks, or by conditions that affect the entire body, such as medications, allergic reactions, or infections. A form of stomatitis known as stomatitis nicotina can be caused by smoking cigars, cigarettes, and pipes, and is characterized by small red bumps on the roof of the mouth.

When it also involves an inflammation of the gingiva, it is called gingivostomatitis. Irritation and fissuring in the corners of the lips is termed angular stomatits or angular cheilitis. In children a frequent cause is repeated lip-licking and in adults it may be a sign of underlying iron deficiency anemia, or vitamin B deficiencis (e.g. B2-riboflavin, B9-folate or B12-cobalamins), which in turn may be evidence of poor diets or malnutrition (e.g. celiac disease).

Historical Perspective

• Between460-370 B.C., in relation to disorders of the mouth the term aphthae was first used by Hippocrates.
• In 1898, the first clinical description of the aphthous stomatitis was reported by Von Mikulicz and Kumme as a Mikuliez aphthea
• In 1911, stomatitis aphthae recurrens cicatricicans was first described by Sutton.
• In 1961, stomatitis aphthae recurrens herpetiformis was first described by Cooke.

Classification

According to the etiology, stomatitis may be classified into:

Infectious Stomatitis

• Aphthous stomatitis
  • Major aphthous stomatitis
  • Minor aphthous stomatitis
  • Herpetiform stomatitis
• Herpetic gingivostomatitis
• Necrotizing ulcerative stomatitis or stomatitis gangrenosa
• Vesicular stomatitis
• Enteroviral vesicular stomatitis with exanthem
• Candidal stomatitis

Other forms

• Angular stomatitis
• Denture stomatitis
• Contact stomatitis
• Migratory stomatitis or geographic stomatitis
• Stomatitis nicotina
• Pyostomatitis vegetans

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• Ebola

Common Causes

• Aphthous stomatitis
• Dentures
• Folate deficiency
• Herpes stomatitis
• Oropharyngeal candidiasis
• Vitamin B12 deficiency

Causes by Organ System

Cardiovascular	Kawasaki disease
Chemical/Poisoning	Bismuthia, gold, mercury poisoning, nickel, thallium
Dental	Angular cheilitis, angular stomatitis, aphthous stomatitis, aphthous ulcer, burning mouth syndrome, dentures, desquamative gingivitis, dry mouth, herpetic gingivostomatitis, hypertrophic gums, nicotine stomatitis, oral lesions, oral submucous fibrosis, oral ulceration, trench mouth, ulcerative gingivitis, Vincent's angina
Dermatologic	Behcet's disease, bismuthia, erythema multiforme, gluten-sensitive enteropathy associated conditions, lip balm, pemphigoid, Stevens-Johnson syndrome, vesicular stomatitis with exanthem, warts
Drug Side Effect	Acmella oleracea, afatinib, aflibercept, alemtuzumab, aminopterin, aralen phosphate, auranofin, benzydamine, bleomycin, boceprevir, busulfan, cabozantinib, capecitabine, carboplatin, cerubidine, chemotherapy, chloramphenicol, chloroquine phosphate, clofibrate, cosmegen, cyclophosphamide, cytosine arabinoside, dacarbazine, dactinomycin, daptomycin, daunorubicin, docetaxel, epirubicin,eribulin, etoposide, everolimus, floxuridine, fluorouracil, gemcitabine, gemtuzumab ozogamicin, gentamicin, ginkgo biloba, hexetidine, ixabepilone, ketorolac tromethamine, lenvatinib, levoleucovorin, lincomycin hydrochloride, lomustine, loratadine, melphalan, methotrexate, metronidazole, mitomycin, mitoxantrone, nabumetone, nicotine polacrilex, oxaliplatin, oxaprozin, oxcarbazepine, palbociclib, panitumumab, paraplatin, penicillin G potassium, pentostatin, peplomycin, pertuzumab, phenylbutazone, pixantrone, pralatrexate, pramipexole, procainamide, sargramostim, sirolimus, sodium aurothiomalate, sorafenib, sulfasalazine, sulindac, sunitinib, temsirolimus, thioguanine, tiagabine, tolmetin, trametinib, ziv-aflibercept
Ear Nose Throat	Angular stomatitis, aphthous stomatitis, aphthous ulcer, glandular fever, oropharyngeal cancer, periodic fever, aphthous stomatitis, pharyngitis and adenitis, trench mouth, uvulitis, Vincent's angina
Endocrine	Glucagonoma
Environmental	No underlying causes
Gastroenterologic	Celiac disease, Crohn's disease, dysphagia, inflammatory bowel disease, odynophagia, oropharyngeal candidiasis, ulcerative colitis
Genetic	Chronic granulomatous disease
Hematologic	Agranulocytosis, anemia, cyclic neutropenia, iron deficiency anemia, leukemia, neutropenia
Iatrogenic	Irradiation
Infectious Disease	Aphthous stomatitis, aphthous ulcer, arbovirus, baculovirus, bovine papular stomatitis, candidiasis, coxsackie virus, diphtheritic stomatitis, ebola, esophageal candidiasis, feline calicivirus, feline immunodeficiency virus, gangrenous stomatitis, glandular fever, hand-foot-and-mouth disease, herpangina, herpes simplex virus, herpes zoster, herpes, herpetic gingivostomatitis, HIV, infectious stomatitis, lassa fever, lichen planus, Marburg virus, noma (disease), oncolytic virus, oropharyngeal candidiasis, parapoxvirus, periodic fever, aphthous stomatitis, pharyngitis and adenitis, syphilis, trench mouth, tuberculosis, typhlitis, vesicular stomatitis virus, vesicular stomatitis with exanthem, vesiculovirus, Vincent's angina, warts
Musculoskeletal/Orthopedic	Odynophagia
Neurologic	Parkinson's disease
Nutritional/Metabolic	Angular cheilitis, ariboflavinosis, folate deficiency, kwashiorkor, lingzhi, nutritional deficiency, pyrophosphate, vitamin B12 deficiency, vitamin B2 deficiency, vitamin B6 deficiency, vitamin C deficiency
Obstetric/Gynecologic	Warts
Oncologic	Cancer, glucagonoma, leukemia, oropharyngeal cancer
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	Emotional stress
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	Allergies, autoimmune diseases, Behcet's disease, chronic granulomatous disease, combined immunodeficiencies, drug hypersensitivity, gluten-sensitive enteropathy associated conditions, pemphigoid, periodic fever syndrome, systemic lupus erythematosus, TNF receptor associated periodic syndrome
Sexual	No underlying causes
Trauma	Trauma
Urologic	No underlying causes
Miscellaneous	Mucosa hemorrhage

Causes in Alphabetical Order

The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.

3