The document provides a comprehensive overview of various mucous membrane disorders, including their types, signs, symptoms, diagnosis, and treatment options. Key conditions discussed include cheilitis, stomatitis, and gingivitis, each associated with distinct causes and management strategies. The information aims to equip nursing students with essential knowledge about these medical conditions.

1. MUCOUS MEMBRANE
DISORDERS 1
DEPARTMENT OF MEDICAL SURGICAL NURSING

2. LEARNING OBJECTIVES
At the end of this class the students
should be able to:-
• Enumerate the different types of
mucous membrane disorders.
• Enlist the signs and symptoms of
mucous membrane disorders.
• Explain the diagnosis and treatment of
mucous membrane disorders.

3. CHEILITIS
• Cheilitis is a medical condition that results
in inflammation of lips marked by one or
more symptoms such as redness, itching,
swelling, dryness, crack.
• Cheilitis can be affects a side effect of
certain drugs, high dose of vitamin A, iron
deficiency, vitamin B12 deficiency, and
oral candidiasis

4. Causes
• Dry or chapped lips : exposure to
harsh weather condition, dehydration or
habitual lip licking can leads to dry and
chapped lips
• Infection: bacterial, viral or fungal
infection
• Sun exposure
• Contact dermatitis

5. • Nutritional deficiency
• Auto immune condition

6. Types
• Cheilitis Exfoliativa
• Allergic Contact Cheilitis
• Actinic Cheilitis
• Cheilitis Glandularis
• Angular Cheilitis

7. CHEILITIS EXFOLIATIVA
• Most Common upper lip if cause is unknown.
• Most Common lower lip if it is a reaction to
other disease states, ie. Sickle cell,
Alzheimer’s Disease.
• Irritation: lipsticks, dentifrices, mouthwashes,
shaving/aftershave, nail enamel, lip licking, UV
• Tx: Remove cause, topical steroids, emollient
ointments

8. Allergic Contact Cheilitis
• dryness, fissuring, edema, crusting,
angular cheilitis.
• Topicals - meds, dental, lipsticks,
sunscreen lip balms, cosmetics, nail
polish, cigarette holders, rubber, metals,
toothpaste.
• Foods – oranges, lemons, artichokes,
mangoes
• Saxophone or Clarinet cane reeds
• Tx: avoid antigen, topical steroids

10. Actinic Cheilitis
• It is precancerous lesion that forms most
commonly on Lower lip
• Ulceration is rare
• Hereditary
• Treatment: Biopsy if thickened or
ulcerated, Cyro, 5-FU, CO2 laser,
Vermilionectomy,
• Photodynamic Therapy with 5-ALA

12. Cheilitis Glandularis
• Swelling and eversion of lower lip with
patulous openings of the ducts of the
mucous glands - Chronic, inflammatory.
• Mucous exudes freely to form a glue-like
film, lips stick together, palpation feels
like pebbles beneath the surface.
• Etiology: irritation, atopic, factitious,
actinic

13. Cheilitis Glandularis
“STICKY LIPS”
TX SAME
AS ACTINIC
CHEILITIS

14. Angular Cheilitis (Perleche)
• Most Common cause Candida albicans
• Elderly – facial and dental architecture
• Youth – thumbsucking, lollipops,
• Thrush in DM II or HIV, Deficiency of
Iron, Riboflavin, Vitamin A, E, etc.

15. Treatment: Dental consultation - dentures
hydrocortisone ointment.
Injection of dermal filler substances, excision of
flap.

16. Oral Crohn’s Disease
• 10-20% of Crohn’s patients
• 90% have granulomas on biopsy
• Inflammatory hyperplasia of oral mucosa,
cobblestoning, fissuring,
• Metallic dysgeusia
• Gingival bleeding
• Metastatic Crohn’s – non-caseating
granulomatous skin lesions in patients with
Crohn’s.

17. Treatment – oral budesonide, mouthwash containing
triamcinolone, tetracycline and lidocaine, oral
metronidazole, Curettage & Zinc by mouth. Sulfasalazine,
Asacol, Pentasa.

18. Stomatitis
• Stomatitis is an inflammation of the
mucous lining of the mouth, which may
involve the cheeks, gums, tongue, lips,
and roof or floor of the mouth.

19. Causes
• Chemotherapy
• Radiotherapy
• Loose-fitting dental prosthetics
• Trauma
• Poor dental hygiene
• Smoking
• Hematological malignancies

20. • Infection
• Dehydration
• Medication

21. Signs and symptoms
• Pain or discomfort in the mouth
• The presence of open sores or ulcers in
the mouth
• Fever
• Irritability and restlessness
• Blisters in the mouth
• Swollen gums

22. • Drooling
• Dysphagia
• Foul smelling breath

23. Type of stomatitis
• Nutritional deficiency stomatitis
• Aphthous stomatitis
• Angular stomatitis
• Denture related stomatitis
• Allergic contact stomatitis
• Migratory stomatitis

24. Management
• Coating agents such as bismuth salicylate,
sucralfate, or other antacids
• Water soluble lubricants for mouth and lips
• Topical analgesics such as lidocaine
viscous (might impair gag reflex for a short
period)
• Oral or parenteral analgesics including
opioids

25. • Antiseptic mouthwash
• Protective pastes
• Local anesthetic mouthwash or spray
• Oral analgesics
• Tropical corticosteroids

27. Gingivitis
• Gingivitis is a form of gum disease
characterized by reversible gingival
inflammation without destruction of tooth-
supporting tissues, periodontal ligament
or bone

28. Etiology
• Bacterial infection
• Immuno-inflammatory response
• Genetic: family history
• Habits : smoking, tobacco.
• Systemic disease or condition: pregnancy,
diabetes mellitus.
• Age : adults are more likely to have
gingivitis

29. • Plaque
• Poor oral hygiene
• Hormonal changes
• Medication : birth control pills, phenytoin
• Dental work : fitting or unclean
dentures, bridges, crowns
• Vitamin deficiency : vitamin B12

30. Types
• Plaque induced
• Non plaque induced

31. Clinical features
• Redness
• Swollen gum
• Bleeding upon
provocation
• Sponginess
• halitosis

32. Diagnosis
• History collection
• Physical examination
• X-ray

33. Complication

34. Treatment
• Professional cleaning : A
dentist or hygienist will
remove plaque, tartar, and
bacteria from your teeth and
gums with a procedure
called scaling and root
planing.

35. • Dental repairs : If poorly fitting crowns,
bridges, or fillings are contributing to
gingivitis
• Oral hygiene: need to maintain good oral
hygiene at home, including brushing and
flossing regularly.
• Antimicrobial mouthwash: Rinsing with an
antimicrobial mouthwash can help destroy
disease-causing bacteria.
• Antibiotics : metronidazole are used for the
treatment of gingivitis

36. SUMMARY
In this class we discussed the:-
• Different types of mucous membrane
disorders.
• Signs and symptoms of mucous
membrane disorders.
• Diagnosis and treatment of mucous
membrane disorders.

37. BIBLIOGRAPHY
• Lewis et al, Medical Surgical Nursing, Mosby
Elsevier,7th
edition.
• Joyce.M.Black et al, Medical Surgical
Nursing, Saunders publication.
• Brunner and Siddhartha, Medical Surgical
Nursing, Lippincott Williams and Wilkins.