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Oral ulcers
 

Oral ulcers

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    Oral ulcers Oral ulcers Presentation Transcript

    • Oral ulcers
    • 1ry Herpes simplex Onset: after 6 months ,Peak within 2-3 years Clinical features: Prodrome :1-2 days before appearance of local lesions(fever ,headache ,lymphadenopathy, malaise ,vomiting) -generalized acute marginal gingivitis -multiple vesicles turn to painful, bilateral ulcers surrounded by erythtematous halo -mainly keratinized gingiva -mainly at anterior area of oral cavity
    • Herpangina By coxsackievirus A4 Affect children from 3-10 years ,peak from june to october Clinical picture : -prodrome ,milder than herpes simplex (fever ,anorexia ,malaise) -sore throat ,dysphagia -ulcers mainly at post .area of oral cavity (soft palate ,fauces ,tonsills ,posterior pharynx) Diagnosis: -ulcers smaller than herpes -at post area -no marginal gingivitis -more painfull ,sore throat -milder prodrome -mainly in epidemics
    • Hand- foot and mouth disease Caused by coxsakievirus A16,from 8 months to 33 years ,75%under 4 years. Clinical picture: -low grade fever -oral vesicles and ulcers more extensive than herpes -macules and papules on extensor surface of hand and feet. -stomatitis Diagnosis: -marginal gingivitis(stomatitis) -examine hands and feet for maculopapular lesions and vesicles if there is acute stomatitis and fever
    • Chicken pox 1ry infection of varicella – zoster infection. Clinical picture: Maculopapular lesion then turn to vesicles on erythematous base Oral lesions not diagnostic
    • Herpes zoster (shingles) Prodrome 2-4 days (shooting pain, paresthesia,burning sensation)along the course of the nerve Clinical picture: -unilateral vesicles on erythematous base ,appears as clusters along the course of the nerve. Diagnosis : the most diagnostic manifestation is the unilateral appearance of lesions