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Oral Ulcers (oral + ulcer)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Dermatology	46%
Gastroenterology	7%

Kinds of Oral Ulcers

chronic oral ulcer

Selected Abstracts

Oral ulcers: clinical aspects.

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2009
A tool for dermatologists.
Summary Oral ulcers are generally painful lesions that are related to various conditions developing within the oral cavity. They can be classified as acute or chronic according to their presentation and progression. Acute oral ulcers are be associated with conditions such as trauma, recurrent aphthous stomatitis, Behçet's disease, bacterial and viral infections, allergic reactions or adverse drug reactions. Chronic oral ulcers are associated with conditions such as oral lichen planus, pemphigus vulgaris, mucosal pemphigoid, lupus erythematosus, mycosis and some bacterial and parasitic diseases. The correct differential diagnosis is necessary to establish the appropriate treatment, taking into account all the possible causes of ulcers in the oral cavity. In this second part of this two-part review, chronic oral ulcers are reviewed. [source]

Oral ulcers: clinical aspects.

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2009
A tool for dermatologists.
Summary Oral ulcers are generally painful lesions that are related to various conditions developing within the oral cavity. They can be classified as acute or chronic according to their presentation and progression. Acute oral ulcers are be associated with conditions such as trauma, recurrent aphthous stomatitis, Behçet's disease, bacterial and viral infections, allergic reactions or adverse drug reactions. Chronic oral ulcers are associated with conditions such as oral lichen planus, pemphigus vulgaris, mucosal pemphigoid, lupus erythematosus, mycosis and some bacterial and parasitic diseases. The correct differential diagnosis is necessary to establish the appropriate treatment, taking into account all the possible causes of ulcers in the oral cavity. In the first part of this two-part review, acute oral ulcers are reviewed. [source]

Pararenal retroperitoneal Castleman's disease mimicking systemic lupus erythematosus

INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2010
Ki-Jo KIM
Abstract A 41-year-old man diagnosed initially as probable systemic lupus erythematosus (SLE) visited our hospital complaining of a persistent painful oral ulcer and multiple spots like coffee beans on his trunk. Antibodies except for anti-dsDNA and anti-histone antibodies and other serologies were negative. Conventional cytotoxic and immunomodulatory agents did not have any effect on these lesions. Computed tomography for evaluating persistent dry cough incidentally showed a huge mass in the left mid-retroperitoneum. Surgical treatment was done and the final diagnosis was Castleman's disease (CD). CD is a relatively rare disorder characterized by a massive non-malignant tumor of lymphoid tissues, with unknown etiology. It commonly presents as a localized soft tissue mass within the mediastinum or neck, and rarely in the retroperitoneal space. Since some cases of CD may share systemic, immune and histopathologic features of autoimmune disease, exact diagnosis is difficult to make based on the clinical and laboratory clues alone. We report herein an unusual case with pararenal retroperitoneal CD mimicking SLE. [source]

Chronic oral ulcer associated with Candida

MYCOSES, Issue 2 2010
Haruhiko Terai
Summary In the patients with HIV infection, fungal diseases may cause ulceration in the oral cavity; however, there have been few studies on oral ulcerative lesions associated with Candida in the patients without HIV infection. Our study included six patients with chronic oral ulcer of unknown origin; these patients were referred to our department after topical steroid therapy to the lesion was ineffective. Cases of traumatic ulcers and recurrent aphthous stomatitis were excluded. Blood, histopathological, culture and direct cytological examinations were performed. All the patients were treated with topical miconazole gel. Histopathological examination revealed no specific findings besides inflammatory cellular infiltration with positive haematoxylin,eosin staining in all cases. Candida spp. were isolated in four cases by culture test, and fungal pseudohyphae were revealed in four cases by direct examination. The anti-fungal treatment produced a satisfactory outcome with complete remission in five cases and remarkable response in one case. These results suggested that Candida should be considered as playing an important role in a certain oral ulcer. [source]

Solitary oral ulceration as the first appearance of lymphomatoid papulosis: a diagnostic challenge

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2 2010
R. F. De-Misa
Summary Lymphomatoid papulosis (LyP) may involve any cutaneous site but the oral areas seems to be an unusual location. We report a 72-year-old patient who presented with a 1-week history of a solitary oral ulcer on the lateral tongue, which had raised and indurated borders. Although squamous cell carcinoma was initially diagnosed, the morphological, phenotypical and genotypical studies confirmed diagnosis of LyP. We are not aware of previous reports of definite LyP presenting as oral lesions, which may pose a diagnostic challenge. The differential diagnosis includes several neoplastic, reactive and infectious disorders. LyP should be considered in patients showing solitary, rapidly developing ulcers with raised, indurated borders in the oral cavity. [source]

Oral biopsies from patients with orofacial granulomatosis with histology resembling Crohn's disease have a prominent Th1 environment

INFLAMMATORY BOWEL DISEASES, Issue 4 2007
Jona Freysdottir BSc
Abstract Background: Orofacial granulomatosis (OFG) is an idiopathic inflammatory disorder of children and young adults whose clinical symptoms include swelling of the lips or face, mucosal nodularity (cobblestoning), mucosal tags, hyperplasia of the gingivae, and aphthous oral ulcers. Whether some OFG patients with clinical and histological characteristics resembling Crohn's disease (CD) are a special group (oral CD) or true CD patients with symptoms reaching all the way to the oral mucosa remains to be determined. Methods: In this study oral biopsies from 10 patients with OFG were analyzed for the presence of T cells, T-cell subsets, B cells, and macrophages, as well as cytokines (IL-4, IL-10, IFN-,, IL-12, and TNF-,), chemokines (RANTES and MIP-1,), and chemokine receptors (CCR3, CCR5, and CXCR3). For comparison, oral tissues from 7 patients with other granulomatous diseases were included. Results: Compared with the non-OFG group, the OFG group had raised levels of CD4+ T cells, IFN-,, IL-10, and RANTES but reduced levels of CD68+ macrophages outside the granulomas, whereas within the granulomas the levels of CD3+ and CD4+ T cells and of IFN-, were raised, but the levels of IL-4 were decreased. These data are indicative of a Th1 environment within the oral OFG tissues, which resembles that already observed in gut CD tissues. Conclusions: Therefore, it can be concluded that some OFG patients have both histopathological and immunopathological features that resemble those observed in CD patients. (Inflamm Bowel Dis 2006) [source]

Nodular vasculitis in systemic lupus erythematosus

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2008
Annet Westers-Attema MD
A 42-year-old man presented with fever, photosensitivity, headaches, myalgia, hyperhidrosis, muscle weakness, alopecia, nasal crustae, weight loss, painful nails, arthritis, oral ulcers, erythema, discoid cutaneous lesions, and painful subcutaneous nodes. We made a diagnosis of systemic lupus erythematosus (SLE), type II cryoglobulinemia, and nodular vasculitis. In the skin, different types of vasculitis may be observed. Typically, histology shows leukocytoclastic vasculitis of superficial vessels both in SLE and mixed cryoglobulinemia, which clinically results in palpable purpura. In our patient, however, histopathological examination of the subcutaneous nodes not only revealed leukocytoclastic vasculitis of the superficial vasculature but also showed even more extensive involvement of dermal and subdermal small and medium sized vessels, giving rise to a nodular vasculitis. [source]

Intraoral condition in children with juvenile idiopathic arthritis compared to controls

INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2008
EVA LEKSELL
Aims. The aims of this study were to compare the periodontal conditions in children and adolescents with juvenile idiopathic arthritis (JIA) in comparison to age-matched healthy individuals, and to describe intraoral health in relation to medical assessments. Design. Forty-one JIA patients, 10,19 years old, were compared to 41 controls. Plaque, calculus, probing depth, bleeding on probing, clinical attachment loss, as well as mucosal lesions were registered. Marginal bone level was recorded on radiographs. A questionnaire was included. Data were analysed with chi-squared test, Fisher's exact test, and Mann,Whitney U -test (P < 0.05). Results. The JIA patients reported pain from jaws (P = 0.001), hands (P = 0.001), and oral ulcers (P = 0.015) more often than controls. They avoided certain types of food because of oral ulcers (P = 0.037). The frequencies of sites with plaque (32% vs. 19%, P = 0.013), calculus (11% vs. 5%, 5 = 0.034), bleeding on probing (26% vs. 14%, P < 0.01), and probing depth 2 mm (32% vs. 2%, P < 0.001) were higher among JIA patients. No sites with attachment loss or reduced marginal bone level were observed. Conclusions. These obtained results are probably because of joint pain, making it difficult to perform oral hygiene as well as the use of medication and general disease activity. [source]

A case of Adamantiades-Behçet disease with ischemic optic neuritis (posterior optic neuropathy)

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 11 2007
Satoko Shima
Summary Adamantiades-Behçet disease (ABD) may present with cutaneous and ophthalmologic finings. A 29-year old woman complained of fever and general fatigue, along with erythema nodosum and vesiculo-pustular lesions on the legs, acneiform lesions, genital ulcerations and painful oral ulcers. She also complained of reduced visual acuity, visual disturbance and blurred vision in the left eye. Her left visual acuity was 6/20. Light reflex in the left eye was reduced. The relative afferent pupillary defect (RAPD) was positive in the left eye where a central scotoma was present. The vitreous was clear; the optic disc, macula, retina and iris were all normal. Uveitis was not observed. The patient was diagnosed with ischemic optic neuritis (posterior optic neuropathy) with ABD. Histopathological findings taken from a blister on the leg showed subepidermal bulla, dense dermal neutrophil infiltration, and extravasation of erythrocytes, suggesting leukocytoclastic vas-culitis. She was treated orally with high-dose corticosteroids (methylprednisolone 500 mg/d) for three days. Her general condition and ophthalmic symptoms resolved completely. Optic neuropathy with ABD is very rare; we know of two previous cases [1, 2] of ABD with ischemic posterior optic neuritis. [source]

Clinical aspects of ulcerative colitis in mainland China

JOURNAL OF DIGESTIVE DISEASES, Issue 2 2006
Jia Ju ZHENG
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is reported to be increasing in incidence and prevalence in provinces and cities in mainland China. This article specifically reviews clinical features, extra-intestinal manifestations, complications, diagnosis and differential diagnosis, and medical treatment of UC. Compared to patients in Western countries, more mild to moderate and left-sided colitis cases were observed in a nation-wide study in China. Complications included anal fistula, anal abscess, anal fissure, severe bleeding, intestinal perforation, intestinal obstruction and colonic carcinoma. The extra-intestinal manifestations were arthritis/arthralgia, eye and skin disorders and oral ulcers. The high specificity of antineutrophil cytoplasmic antibody may useful for distinguishing UC from infectious colitis; in addition, serum levels of antisaccharomyces cerevisia antibody may helpful for distinguishing between UC and CD. Oral sulfasalazine and 5-aminosalicylic acid (ASA) remain the mainstays for the management of mild to moderate UC in China. Corticosteroids and immunosuppressive agents are also widely used in severe or refractory UC. [source]

Long-standing oral ulcers: proposal for a new ,S-C-D classification system'

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 6 2010
Dr Dimitris Triantos DDS
No abstract is available for this article. [source]

Long-standing oral ulcers: proposal for a new ,S-C-D classification system': Authors' reply

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 6 2010
D. Compilato
No abstract is available for this article. [source]

Oral health and related quality of life status in patients from UK and Turkey: a comparative study in Behcet's disease

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 5 2009
G. Mumcu
Background:, The aim of this study was to evaluate and compare oral health-related quality of life (oral QoL) in patients from UK and Turkey with Behcet's disease (BD). Methods:, Thirty-one BD patients from UK (F/M: 18/13, mean age: 41.8 ± 11.5 years) and Turkey (F/M: 18/13, mean age: 41.5 ± 10.3) who were matched according to age and gender were included in the study. All patients had active oral ulcers. Oral QoL was assessed by Oral Health Impact Profile-14 (OHIP-14). Oral health was evaluated by dental and periodontal indices. Results:, No significant difference was found in OHIP-14 scores between patients from UK (22.7 ± 14.4) and Turkey (20.4 ± 14.3) (P = 0.709). The OHIP-14 score correlated with the healing time of oral ulcers in UK (r = 0.4, P = 0.04) and the number of oral ulcers in Turkey (r = 0.4, P = 0.012). The number of oral ulcers per month was significantly higher in UK (3.3 ± 2.8) compared with that in Turkey (1.5 ± 2.5) (P = 0.014). However, the number of filled teeth and frequency of tooth brushing were significantly lower in patients from Turkey compared with those in UK (P = 0.000). Similarly, the duration since the last dental visit (5.1 ± 7.2 months) was significantly lower in UK compared with that in Turkey (28.6 ± 23.7 months) (P = 0.000). Conclusions:, Oral QoL was similar in patients from UK and Turkey with active oral ulcers. However, the number of oral ulcers was observed to be higher in UK. As expected, a lower utilization rate of dental services might have led to a poorer oral health in patients from Turkey. [source]

Dysfunction of CD4+CD25high T regulatory cells in patients with recurrent aphthous stomatitis

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 8 2008
Natalia Lewkowicz
Background:, Recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease of unknown etiology characterized by recurring formation of painful oral ulcers. RAS may result from oral epithelium damage caused by T-cell-mediated immune response. CD4+CD25+ T regulatory (Treg) cells suppress proliferation and effector functions of other immune cells, and therefore are crucial in regulating the immune response. Methods:, We tested the function of peripheral CD4+CD25high Treg cells in active RAS through their ability to inhibit proliferation and cytokine production of conventional CD4+ T cells. We also attempted to detect the presence of FOXP3 and indoleamine 2,3-dioxygenase (IDO) mRNA in the lesional and non-lesional oral mucosa of RAS patients and healthy individuals using real-time PCR assay. Results:, Treg cells derived from RAS patients were less efficient in the suppression of cytokine production of CD4+ T effector cells than Treg cells from healthy individuals. Moreover, in RAS, Treg cells were nearly twice less potent in the inhibition of CD4+CD25, T cell proliferation than in healthy donors. Furthermore, we have demonstrated the decreased proportion of CD4+CD25+FOXP3+ Treg cells in peripheral blood of RAS patients compared with controls. We failed to detect FOXP3 mRNA, while IDO mRNA expression was decreased in non-lesional mucosa biopsies from RAS patients compared with ulcer biopsies or normal mucosa from healthy donors. Conclusions:, These findings suggest that CD4+CD25high Treg cells are both functionally and quantitatively compromised in RAS and that decreased constitutive expression of IDO in oral mucosa in RAS may lead to the loss of local immune tolerance. [source]

Propylthiouracil-induced vasculitic oral ulcers with anti-neutrophil cytoplasmic antibody

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2006
Y Karincaoglu
[source]

Review article: oral ulcers and its relevance to systemic disorders

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2005
S. R. Porter
Summary Oral ulceration is a common problem, and is sometimes a marker of gastroenterological disease. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease. Indeed, a spectrum of disorders other than those of the gut can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. This present article reviews aspects of the aetiology, diagnosis and management of common ulcerative disorders of the oral mucosa. [source]

Conversion to sirolimus-based immunosuppression in maintenance liver transplantation patients

LIVER TRANSPLANTATION, Issue 5 2007
Isabelle Morard
Sirolimus (SRL) has been proposed to replace calcineurin inhibitors (CNI) in case of CNI-induced toxicity. The aim of this study was to evaluate the efficacy and safety of conversion from CNI to SRL in maintenance liver transplantation (LT) patients. Between 2002 and 2006, conversion was performed in 48 patients (17 female, 31 male; mean age 57 ± 10 yr) after a median delay of 19.4 months (range 0.2,173 months) after LT. Indication for conversion was renal impairment (RI) (78%), CNI neurotoxicity (13%), or post-LT cancer (9%). Median follow-up was 22.6 ± 11 months. Median SRL dosage and trough levels were 2.4 ± 1.3 mg and 8.1 ± 2.7 ,g/L. Immunosuppression consisted of SRL alone (33%), or SRL + mycophenolate mofetil (MMF) (39%), SRL + prednisone (15%), SRL + CNI (4%), or SRL + MMF + prednisone (8%). Mean glomerular filtration rate (GFR) improved from 33 to 48 mL/minute in patients with severe RI (P = 0.022) and from 56 to 74 mL/minute in patients with moderate RI (P = 0.0001). After conversion, main complications were albuminuria (36%), hyperlipidemia (49%), dermatitis (14%), edema (14%), oral ulcers (12%), joint pain (4%), infection (2%), and pneumonia (2%). Acute rejection (AR) occurred in 17% of the patients. SRL was withdrawn in 17% of the patients. In conclusion, conversion from CNI to SRL is safe and is associated with significant renal function improvement. Liver Transpl 13:658,664, 2007. © 2007 AASLD. [source]

Oral ulceration: GP guide to diagnosis and treatment

PRESCRIBER, Issue 5 2006
FDSRCS, FFDRCSI, MB BS, Stephen Flint MA
Simple mouth ulcers are usually self-limiting and rarely present in general practice. However, severe, recurrent or persistent oral ulceration can be extremely painful and may result from an underlying systemic pathology. Dr Flint describes the different causes of oral ulcers and discusses treatment options. Copyright © 2006 Wiley Interface Ltd [source]

Expanding the phenotypic spectrum of lupus erythematosus in Aicardi-Goutières syndrome

ARTHRITIS & RHEUMATISM, Issue 5 2010
Georgia Ramantani
Objective Aicardi-Goutières syndrome (AGS) is an early-onset encephalopathy resembling congenital viral infection that is characterized by basal ganglia calcifications, loss of white matter, cerebrospinal fluid (CSF) lymphocytosis, and elevated interferon-, levels in the CSF. Studies have shown that AGS is an autosomal-recessive disease linked to mutations in 5 genes, encoding the 3,-repair DNA exonuclease 1 (TREX1), the 3 subunits of ribonuclease H2 (RNASEH2A,C), and sterile alpha motif domain and HD domain,containing protein 1 (SAMHD1). In this study we further characterized the phenotypic spectrum of this disease. Methods Clinical and laboratory data were obtained from 26 patients fulfilling the clinical diagnostic criteria for AGS. Genomic DNA was screened for mutations in all 5 AGS genes by direct sequencing, and sera were analyzed for autoantibodies. Results In 20 patients with AGS, 20 mutations, 12 of which were novel, were identified in all 5 AGS genes. Clinical and laboratory investigations revealed a high prevalence of features (some not previously described in patients with AGS) that are commonly seen in patients with systemic lupus erythematosus (SLE), such as thrombocytopenia, leukocytopenia, antinuclear antibodies, erythematous lesions, oral ulcers, and arthritis, which were observed in 12 (60%) of 20 patients with AGS. Moreover, the coexistence of AGS and SLE, was for the first time, demonstrated in 2 patients with molecularly proven AGS. Conclusion These findings expand the phenotypic spectrum of lupus erythematosus in AGS and provide further insight into its disease mechanisms by showing that activation of the innate immune system as a result of inherited defects in nucleic acid metabolism could lead to systemic autoimmunity. [source]