Ulcerative lesions

Question 1

What are THREE differences of acute and chronic traumatic lesions?

Answer 1

• Pain vs. not painful (chronic)
• Margins red vs. elevated (chronic)
• Surface covered in yellow exudate vs. indurated (chronic)

Question 2

Traumatic eosinophilic ulcer:

• Clinical presentation
• Histology

Answer 2

• Chronic ulcer 1-2cm (months, often heals quicker after biopsy)
• Lots of eosinophils and macrophages

Question 3

How do you identify granulation tissue histologically?

Answer 3

Immature fibroblasts, vascular, lots of inflammation, layer of dead cells on surface.
NOTE: immature fibroblasts have plump nuclei (forming lots of collagen), while mature ones have squished nuclei.

Question 4

Traumatic eosinophilic ulcers, major aphthous ulcers and malignant (endophytic) lesions all have similar clinical presentation. What is one way to differentiate them? (not histologically)

Answer 4

Apply topical corticosteroid to them. Malignant lesions will not heal after a few days like the others will.

Question 5

Differentiate between minor, major and herpetiform ulcers.

Answer 5

• Size: minor (5-7mm), major (cms), herpetiform (1-2mm, may coalesce)
• Healing: minor/herpetiform (5-7 days), major (months)

Question 6

One tip for applying Kenalog orabase?

Answer 6

Dry area before application.

Question 7

Crohn’s disease in a type of inflammatory Bowel Disease.

What are THREE extraoral features of Crohn’s disease and FOUR oral features?

Answer 7

Extraoral (diarrhoea/constipation, abdominal pain, malabsorption)
Intraoral (fibroepithelial polyps, ulcers, diffuse lip swelling, glossitis)
NOTE: histologically lots of granulomatous inflammation

Question 8

Anaemia (lack of RBCs) can cause aphthous ulcers and glossitis. What are TWO types of anaemia?

Answer 8

• Iron deficiency

- Pernicious (lack of B12 and folate)

Question 9

What is Epidemolysis Bullosa?

Answer 9

Genetic condition where desmosomes are broken down leading to loss of epithelium attachment -> ulceration

Question 10

Behcets Disease:

• Prevalent in who?
• Ulceration where?
• Cause? is it contagious?
• Treatment?

Answer 10

• Males, 20-40yo
• Ulcers in mouth, eyes, genitals
• Unknown, maybe genetic. Not contagious.
• Management of Sx