Infection of Oral Musoca

• causes?

  • viral
  • fungal
  • bacterial
• signs and symptoms:

  • prodome - typical viral infection, fever, malaise
  • oral mucosa - vesicles, ulcers, swelling, white/red patches, discharge, sore throat
  • facial swelling, erythema, skin lesion, angular cheilitis, papillomatous lesion, ocular lesion, lymphadenopathy
  • systemic - fever, malaise, loss of appetite, weight loss
• primary herpes simplex

  
• why does HSV infection recur?

  remains latent in trigeminal nerve ganglion
• reactivating factors of HSV?

  • fever
  • sunlight
  • trauma
  • immunosuppression
• tx for HSV?

  aciclovir or penciclovir cream
• recurrent herpes simplex

  
• erytema multiforme

  
• erythema multiforme:

  • acute hypersensitive reaction
  • causes difficult to establish
  • serosanguinous exudate
  • young adults
• chicken pox

  
• small pox

  
• shingles

  
• shingles

  
• shingles

  
• coxsackie viruses:

  • many times
  • transient infection of oral musoca
  • eg herpangina, HFM
  • managed by fluid, analgesia, antipyretics, CHX mw
• herpangina?

  fever, sore throat, ulcers on soft palate, cervical lymphadenopathy
• hand foot and mouth?

  rash, oral ulceration and malaise
• herpangina

  
• Epstein-barr virus?

  • glandular fever
  • fever, sore throat, oral ulceration, lymphadenopathy, petechiae in palate
  • hair leukoplakia in immuno supp pt
  • management - fluids, analgesia, antipyretics, CHX mw
• epstein-barr virus

  
• epstein barr virus

  
• hairy leukoplakia

  
• hairy leukoplakia?

  • causes by epstein-barr
  • in severely immunocompromised pt eg HIV
  • margins of tongue, sometimes dorsum
  • vertically corrugated surface
• HPV

  
• HPV?

  • uncommon in mouth - seen in fauces, soft palate and tongue
  • verrucae vulgaris
  • linked to oropharyngeal and cervical cancer
• Mumps

  
• measles

  
• measles

  
• fungal infection:

  • candidal infections + opportunistic infections
  • deep mycoses
• examples of candida infections:

  • acute pseudomembranous candidiasis
  • acute atrophic (antibiotics)
  • chronic atrophic (denture)
  • angular cheilitis
  • median rhomboidglossitis
  • chronic hyperplastic
  • chronic mucocutaneous
• management of oral thrush?

  • remove predisposing factor
  • topical antifungals - nystatin, miconazole, fluonazole
• oral thrush/ acute pseudomembranous candidosis

  
• oral thrush or pseudomembranous candidosis

  
• denture stomatitis:

  • chronic atrophic candidiasis
  • mild odema and erythema under denture, hyperplastic papules or nodules
  • predisposing factors - denture through night, xerostomia, diabetes, HIV
  • denture hygiene, antifungals, remove cause?
• denture stomatitis

  
• denture stomatitis

  
• angular cheilitis?

  • inflammation at commissures
  • PF: smoking, xerostomia, denture wearing, denture stomatitis
  • reduced verticle dimension
  • deficiency? - iron
  • immune defect? - diabetes, immunosuppressed, Downs, Crohns, orofacial granulomatosis
• angulaar cheilitis

  
• angular cheilitis

  
• management of angular cheilitis?

  • persistent and recurrent
  • mixed infection - c albicans and staph aures and strep
  • stop smoking
  • remove cause
  • miconazole cream/gel
  • consider steriord + antifungal