Oral lesions
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Synonyms and keywords: : Oral cavity lesions, Oral cavity ulcers, Oral cavity infections.
Overview
In many cases, mouth sores are attributed to herpes simplex virus and idiopathic aphthous stomatitis. Oral lesions can be indicative of a more serious underlying condition. A full review of the systems and a full skin exam are necessary to obtain an accurate diagnosis.
Differential diagnosis of oral cavity lesions
Disease | Presentation | Risk Factors | Diagnosis | Affected Organ Systems | Important features | Picture |
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Diseases predominantly affecting the oral cavity | ||||||
Oral Candidiasis |
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Localized candidiasis
Invasive candidasis |
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Herpes simplex oral lesions |
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Aphthous ulcers |
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Squamous cell carcinoma |
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Leukoplakia |
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Melanoma |
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Fordyce spots |
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Burning mouth syndrome |
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Torus palatinus |
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Diseases involving oral cavity and other organ systems | ||||||
Behcet's disease |
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Crohn's disease |
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Agranulocytosis |
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Syphilis |
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Coxsackie virus |
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Chicken pox |
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Measles |
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Causes
Causes in Alphabetical Order[1][2]
- Agranulocytosis
- Aphthous stomatitis
- Allergic contact dermatitis
- Behcet's disease
- Bollus disease
- Chemotherapy drugs
- Erythema multiforme
- Herpes stomatitis
- Histoplasmosis
- Primary syphilis
- Self limited viral disease
- Squamous cell carcinoma
Diagnosis
History and Symptoms
- Past medical/medicinal history
- If the lesions occur in the same locations every time, culpit is HSV
- Consider the patients sexual history
- Evaluate open and mucosal lesions
- Lichen planus - lacy white plaques
Laboratory Findings
- Culture for HSV-1
- RPR
- CBC
- Punch biopsy
Treatment
Medical Therapy
Acute Pharmacotherapies
- Orabase and topical steroids can increase speed of healing
- Aphthous stomatitis - intralesional triamcinalone injections
- HSV (recurrent) - acyclovir
- Bollous disease - corticosteroids