Oral lesions: Difference between revisions
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Revision as of 14:32, 20 August 2012
| Oral lesions |
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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
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
Acute Pharmacotherapies
- Orabase and topical steroids can increase speed of healing
- Aphthous stomatitis - intralesional triamcinalone injections
- HSV (recurrent) - acyclovir
- Bollous disease - corticosteroids