Oral Cavity

Oral Cavity


Lesions involving the mucous membranes of the oral cavity may be confined to the mouth, or they may be associated with widespread cutaneous entities, or with systemic disease. Oral mucous membrane lesions often leave clues to the presence of systemic and cutaneous illnesses such as acquired immunodeficiency syndrome (AIDS), lichen planus, and systemic lupus erythematosus.

Clinical findings may also be helpful in diagnosing the following infectious diseases: measles, hand-foot-and mouth disease, and secondary syphilis. Aphthous ulcers (“canker sores”) are often seen as isolated phenomena, but they may also be an accompaniment or a precursor to a symptom complex, such as seen in Behçet syndrome or ulcerative colitis.


Oral Mucous Cyst (Mucocele)

Distinguishing Features

  • Most commonly occur on the inner surface of the lower lip (Fig. 9-1), but may also appear on the floor of the mouth, buccal mucosa, and tongue

  • Painless, sometimes bothersome, bluish or clear, glistening, dome-shaped cyst that contains mucoid material

  • Bluish color is due to the thin layer of epithelium that covers the capillaries. Deeper lesions are usually the same color as the rest of the lip because they are covered with a thicker layer of tissue

  • Easily ruptured and may spontaneously disappear, particularly in infants

  • May recur repeatedly

Oral Fibroma

Distinguishing Features

  • Asymptomatic, smooth-surfaced, firm solitary papule or nodule (Fig. 9-2)

  • Usually lighter in color than the surrounding normal tissue, with the surface often appearing white

  • Ulceration due to repeated trauma may occur

Aphthous Ulcers

Distinguishing Features

  • Painful lesions may be seen on the buccal, labial, and gingival mucosa, as well as on the tongue

  • Begin as vesiculobullous lesions that rarely remain intact and unruptured; instead, such lesions usually become erosions or ulcers by the time a clinician sees them

  • Single or multiple small (2 to 5 mm) round or oval, shallow, well-demarcated, punched-out erosions covered with gray or yellowish exudate and surrounded by a ring of erythema (halo) (Fig. 9-3)

  • Tend to heal in 4 to 14 days, without scarring

Primary Herpes Gingivostomatosis

Distinguishing Features

  • Initially presents with mouth pain, excessive drooling, irritability, and a child not wanting to eat or drink

  • Fever, which may be high, with malaise, and restlessness

  • Lesions present as painful vesicles on an erythematous base that rapidly evolve into shallow ulcers on the palate, tongue, or gingivae (Fig. 9-5)

  • Gums may be red, swollen, bleed easily, and regional lymphadenopathy is often present

  • Local lymph glands may be enlarged and tender (submandibular or cervical lymphadenopathy)

  • Is usually self-limited and lesions heal within 1 to 2 weeks

  • Some patients may require IV hydration and systemic pain control in addition to antiviral therapy

  • Encephalitis and aseptic meningitis are very rare complications

Jan 8, 2023 | Posted by in Dermatology | Comments Off on Oral Cavity

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