口腔黏膜课件.ppt
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stomach、hepatitis、colonitis、diarrhoea
NEXT
3. Clinical features
minor aphthous ulcer major aphthous ulcer herpetiform ulcer
NEXT
feature
MiAU
yellow red concave painful small (24mm)
Summary & Questions
BACK
I. Introduction
1. Ulcers are one of the most common types of lesions seen in oral mucosa.
2.
2. The difference between ulcer and erosion.
NEXT
6. Differential diagnosis
RAU Herpetic atomatitis Crohn’s disease Reiter’s syndrome Stevens-Johnson syndrome
NEXT
7. Treatment
Symptomatic in mild cases. Systemic steroids, immunosuppressive drugs, colchicines, thalidomide, and dapsone are administered in severe cases.
systemic symptom
—
lymph nodes swelling
HU
multiple small
7-10 days >10
tongue lip mouth floor fever headache lymph nodes swelling
NEXT
Herpetiform ulcers
NEXT
NEXT
2. Etiology unknown
• immunity : cellular immunity, humoral immunity, complement, autoantibody • heritage • infection :HSV • environment: psychology
NEXT
• denutrition :iron, copper, zinc, folic acid,
Vit B12
• hyperoxide dismutase • microcirculation disturbance :lip,
nail, apex linguae
• systemic factor :ulceration of
2. Etiology Unknown
NEXT
3. Clinical features 1) oral mucosa: minor aphthous ulcer
2) genital lesion: ulcer 3) skin lesions: erythema nodosum,
epifolliculitis, pustule after needling
NEXT
6. Differential diagnosis
• benign ulcer & malignant ulcer • Necrotizing sialadenometaplasia,
Behçet’s disease, herpes simplex, hand-foot-and-mouth disease
superficial
free unclear Pemphigus Herpes simplex
BACK
II.Recurrent Aphthous Ulcer
1.Preface
• Name
recurrent aphthous ulcer RAU recurrent aphthous stomatitis RAS recurrent oral ulcer ROU
Physical factors: thermal burns
Chemical factors: strong acid, strong base,
As2O3, Ag(NO)3, iodophenol
NEXT
3. Clinical feature
1) Decubital ulcer
cachexy
chronic inflammation yes
cancer no
NEXT
7. Treatment principle:symptomatic treatment Evaluation of curative effect
NEXT
Topical application of a steroid ointment reduces discomfort and decreases the duration of the lesions. Topical anesthetics, antibiotics, mouthwashes, etc., have been used. In severe cases, intralesional steroid injection or systemic steroids in a low dose (10-20 mg prednisone) for 5-10 days reduce the pain dramatically.
7-10 days >10
tongue lip mouth floor fever headache lymph nodes swelling
NEXT
Major aphthous ulcers Periadenitis Mucosa Necrotica Recurrens
NEXT
Major aphthous ulcers
NEXT
Comparison
age depth self-healing systemic condition pathology recurrence
benign ulcer youth deep yes
malignant ulcer the aged
Deep or shallow no
good
4) ocular lesions: conjunctivitis,
recurrent iritis
5) others systems: joint, digestive,
cardiovascular, nervous, respiratory, urinary
NEXT
BehÇet’s disease
NEXT
ulcer
erosion
NEXT
Comparison
continuity of epithelium
basal cells border diseases
ulcer
broken severe involved clear RAU Behcet’s disease Syphilis
erosion
BACK TO INDEX
口腔粘膜溃疡类疾病
Oral Ulcerative diseases
NEXT
Introduction
Recurrent Aphthous Ulcer BehÇet’s disease Traumatic Ulcer & Traumatic Bulla Reiter’s Syndrome
NEXT
• Typing Lehner’s classification
minor aphthous ulcer (MiAU) major aphthous ulcer (MjAU) herpetiform ulcer (HU)
• Characteristic
recidivity self-healing periodicity
NEXT
4. Pathology :
Histopathologic changes consist of a perivascular mononuclear cellular infiltrate, endothelial cell swelling or necrosis, partial luminal obliteration and occasional fibrinoid necrosis of the vessels.
NEXT
feature
MiAU
yellow red concave painful small (24mm)
MjAU
big (1-3cm) deep scar
course
7-10 days
3-6 weeks
number position
1-5
nonkeratinized oral mucosa
1 soft palate
BACK
III. BehÇet’s disease
1. Preface
Hulusi Behçet (1937) Behçet’s disease is a chronic multisystemic inflammatory disorder of uncertain cause and prognosis.
NEXT
5. Diagnosis
1) recurrent oral ulceration 2) recurrent genital ulceration 3) eye lesions 4) skin lesions 5) positive pathergy test To establish the diagnosis of Behçet’s Disease, recurrent oral ulceration plus any two of the other four major clinical criteria must be present.
MjAU
big (1-3cm) deep scar
course
7-10 days
3-6 weeks
number position
1-5
nonkeratinized oral mucosa
1 soft palate
systemic symptom
—
lymph nodes swelling
HU
multiple small
MjAU
big (1-3cm) deep scar
course
7-10 days
3-6 weeks
number position
1-5
nonkeratinized oral mucosa
1 soft palate
systemic symptom
—
lymph nodes swelling
HU
multiple small
7-10 days >10
tongue lip mouth floor fever headache lymph nodes swelling
NEXT
Minor aphthous ulcers
NEXT
NEXT
feature
ຫໍສະໝຸດ Baidu
MiAU
yellow red concave painful small (24mm)
NEXT
2. Etiology
Mechanical factors: a sharp or broken tooth,
rough fillings, clumsy use of cutting dental instruments, hard foodstuffs, sharp foreign bodies, biting of the mucosa, and denture irritation etc.
BACK
IV. Traumatic Ulcer Traumatic Bulla
1. Preface
Because of the constant motion of the masticatory mucosa over the teeth and the introduction of hard objects into the oral cavity, traumatic ulcers are frequent.
• disease-process
prodromal 24h ulcerative
stage
stage
outbreak
10d-14d
intermission
healing
NEXT
4. Pathology : nonspecific inflammation
5. Diagnosis
• history • clinical feature
NEXT
3. Clinical features
minor aphthous ulcer major aphthous ulcer herpetiform ulcer
NEXT
feature
MiAU
yellow red concave painful small (24mm)
Summary & Questions
BACK
I. Introduction
1. Ulcers are one of the most common types of lesions seen in oral mucosa.
2.
2. The difference between ulcer and erosion.
NEXT
6. Differential diagnosis
RAU Herpetic atomatitis Crohn’s disease Reiter’s syndrome Stevens-Johnson syndrome
NEXT
7. Treatment
Symptomatic in mild cases. Systemic steroids, immunosuppressive drugs, colchicines, thalidomide, and dapsone are administered in severe cases.
systemic symptom
—
lymph nodes swelling
HU
multiple small
7-10 days >10
tongue lip mouth floor fever headache lymph nodes swelling
NEXT
Herpetiform ulcers
NEXT
NEXT
2. Etiology unknown
• immunity : cellular immunity, humoral immunity, complement, autoantibody • heritage • infection :HSV • environment: psychology
NEXT
• denutrition :iron, copper, zinc, folic acid,
Vit B12
• hyperoxide dismutase • microcirculation disturbance :lip,
nail, apex linguae
• systemic factor :ulceration of
2. Etiology Unknown
NEXT
3. Clinical features 1) oral mucosa: minor aphthous ulcer
2) genital lesion: ulcer 3) skin lesions: erythema nodosum,
epifolliculitis, pustule after needling
NEXT
6. Differential diagnosis
• benign ulcer & malignant ulcer • Necrotizing sialadenometaplasia,
Behçet’s disease, herpes simplex, hand-foot-and-mouth disease
superficial
free unclear Pemphigus Herpes simplex
BACK
II.Recurrent Aphthous Ulcer
1.Preface
• Name
recurrent aphthous ulcer RAU recurrent aphthous stomatitis RAS recurrent oral ulcer ROU
Physical factors: thermal burns
Chemical factors: strong acid, strong base,
As2O3, Ag(NO)3, iodophenol
NEXT
3. Clinical feature
1) Decubital ulcer
cachexy
chronic inflammation yes
cancer no
NEXT
7. Treatment principle:symptomatic treatment Evaluation of curative effect
NEXT
Topical application of a steroid ointment reduces discomfort and decreases the duration of the lesions. Topical anesthetics, antibiotics, mouthwashes, etc., have been used. In severe cases, intralesional steroid injection or systemic steroids in a low dose (10-20 mg prednisone) for 5-10 days reduce the pain dramatically.
7-10 days >10
tongue lip mouth floor fever headache lymph nodes swelling
NEXT
Major aphthous ulcers Periadenitis Mucosa Necrotica Recurrens
NEXT
Major aphthous ulcers
NEXT
Comparison
age depth self-healing systemic condition pathology recurrence
benign ulcer youth deep yes
malignant ulcer the aged
Deep or shallow no
good
4) ocular lesions: conjunctivitis,
recurrent iritis
5) others systems: joint, digestive,
cardiovascular, nervous, respiratory, urinary
NEXT
BehÇet’s disease
NEXT
ulcer
erosion
NEXT
Comparison
continuity of epithelium
basal cells border diseases
ulcer
broken severe involved clear RAU Behcet’s disease Syphilis
erosion
BACK TO INDEX
口腔粘膜溃疡类疾病
Oral Ulcerative diseases
NEXT
Introduction
Recurrent Aphthous Ulcer BehÇet’s disease Traumatic Ulcer & Traumatic Bulla Reiter’s Syndrome
NEXT
• Typing Lehner’s classification
minor aphthous ulcer (MiAU) major aphthous ulcer (MjAU) herpetiform ulcer (HU)
• Characteristic
recidivity self-healing periodicity
NEXT
4. Pathology :
Histopathologic changes consist of a perivascular mononuclear cellular infiltrate, endothelial cell swelling or necrosis, partial luminal obliteration and occasional fibrinoid necrosis of the vessels.
NEXT
feature
MiAU
yellow red concave painful small (24mm)
MjAU
big (1-3cm) deep scar
course
7-10 days
3-6 weeks
number position
1-5
nonkeratinized oral mucosa
1 soft palate
BACK
III. BehÇet’s disease
1. Preface
Hulusi Behçet (1937) Behçet’s disease is a chronic multisystemic inflammatory disorder of uncertain cause and prognosis.
NEXT
5. Diagnosis
1) recurrent oral ulceration 2) recurrent genital ulceration 3) eye lesions 4) skin lesions 5) positive pathergy test To establish the diagnosis of Behçet’s Disease, recurrent oral ulceration plus any two of the other four major clinical criteria must be present.
MjAU
big (1-3cm) deep scar
course
7-10 days
3-6 weeks
number position
1-5
nonkeratinized oral mucosa
1 soft palate
systemic symptom
—
lymph nodes swelling
HU
multiple small
MjAU
big (1-3cm) deep scar
course
7-10 days
3-6 weeks
number position
1-5
nonkeratinized oral mucosa
1 soft palate
systemic symptom
—
lymph nodes swelling
HU
multiple small
7-10 days >10
tongue lip mouth floor fever headache lymph nodes swelling
NEXT
Minor aphthous ulcers
NEXT
NEXT
feature
ຫໍສະໝຸດ Baidu
MiAU
yellow red concave painful small (24mm)
NEXT
2. Etiology
Mechanical factors: a sharp or broken tooth,
rough fillings, clumsy use of cutting dental instruments, hard foodstuffs, sharp foreign bodies, biting of the mucosa, and denture irritation etc.
BACK
IV. Traumatic Ulcer Traumatic Bulla
1. Preface
Because of the constant motion of the masticatory mucosa over the teeth and the introduction of hard objects into the oral cavity, traumatic ulcers are frequent.
• disease-process
prodromal 24h ulcerative
stage
stage
outbreak
10d-14d
intermission
healing
NEXT
4. Pathology : nonspecific inflammation
5. Diagnosis
• history • clinical feature