Oral ulcers are not so simple!

I have mouth ulcers again, and I can’t drink spicy food anymore

I have mouth ulcers again, and I can’t drink spicy food anymore

Also known as "aphthous sore", it is a very common oral mucosal disease
.

Also known as "aphthous sore", it is a very common oral mucosal disease
.

It mainly occurs on the soft palate, inner lips and tongue,

It mainly occurs on the soft palate, inner lips and tongue,

Hyperemia at the ulcer point and central mucosa

Hyperemia at the ulcer point and central mucosa

Do you think that common oral ulcers are just oral ulcers?

Do you think that common oral ulcers are just oral ulcers?

It may be the oral manifestation of other diseases!

It may be the oral manifestation of other diseases! It may be the oral manifestation of other diseases! It may be the oral manifestation of other diseases!

 

Recurrent aphthousstomatitis (RAS) is also known as recurrent aphthousstomatitis, recurrent aphthous ulcers, burning pain is its prominent feature, the appearance is a single or multiple round or oval ulcers of different sizes, covering the surface Gray or yellow pseudomembrane, depressed center, clear border, red and slightly swollen surrounding mucosa
.

It has the characteristics of periodicity, recurrence, and self-limiting, regardless of age.

Recurrent aphthousstomatitis (RAS) is also known as recurrent aphthousstomatitis, recurrent aphthous ulcers, burning pain is its prominent feature, the appearance is a single or multiple round or oval ulcers of different sizes, covering the surface Gray or yellow pseudomembrane, depressed center, clear border, red and slightly swollen surrounding mucosa

 

Severe patients with frequent ulcers, such as multiple times a month, ulcers larger than 1 cm, and long healing time, should seek medical treatment in time
.

Many systemic diseases may manifest as recurrent oral ulcers that are not easy to heal.

Severe patients with frequent ulcers, such as multiple times a month, ulcers larger than 1 cm, and long healing time, should seek medical treatment in time

*Patients with chronic gastritis, gastroduodenal ulcer, constipation, hemorrhoids and other gastrointestinal diseases will have a significantly higher incidence of recurrent oral ulcers
.

*Patients with chronic gastritis, gastroduodenal ulcer, constipation, hemorrhoids and other gastrointestinal diseases will have a significantly higher incidence of recurrent oral ulcers
.

*Patients with chronic gastritis, gastroduodenal ulcer, constipation, hemorrhoids and other gastrointestinal diseases will have a significantly higher incidence of recurrent oral ulcers

This is because the structure of the human body's mucous membranes is similar.

Another important reason that patients with gastrointestinal diseases are prone to recurrence of oral ulcers is that the disease affects the body's absorption of vitamins

 

*Herpetic Stomatitis

*Herpetic stomatitis *Herpetic stomatitis

It is common in infants and young children, with systemic symptoms, fever, chills and so on
.

Small clusters of herpes appeared in the mouth, which quickly ruptured to form clusters of small superficial ulcers

It is common in infants and young children, with systemic symptoms, fever, chills and so on

Severe pain, swollen submandibular lymph nodes

 

 

* Stomatitis caused by herpes zoster virus

* Stomatitis caused by herpes zoster virus* Stomatitis caused by herpes zoster virus

It is caused by the varicella-zoster virus
.

It is more common in middle-aged and elderly people, usually for the first time
.
Facial lesions occur in the distribution area of ​​the trigeminal nerve, with severe pain, blisters clustered or scattered, and can merge with each other
.
After the oral mucosa blister breaks, ulcers are formed, and the skin blister breaks and scabs
.

It is caused by the varicella-zoster virus
.
It is more common in middle-aged and elderly people, usually for the first time
.
Facial lesions occur in the distribution area of ​​the trigeminal nerve, with severe pain, blisters clustered or scattered, and can merge with each other
.
After the oral mucosa blister breaks, ulcers are formed, and the skin blister breaks and scabs
.

 

 

*The etiology of necrotizing sialometadysplasia is
unknown
.
It is generally believed that infarct necrotic inflammation occurs due to ischemia
.
It is more common in the palate, especially at the junction of the hard and soft palate (90%)-crater-like ulcer, which is clearly separated from the surrounding area
.
There is granulation tissue on the surface of the ulcer with a raised edge
.
The ulcers are 1-3cm in diameter and usually heal within 4-10 months
.
The ulcer can reach the bone surface, but X-ray showed no bone destruction
.

*Necrotizing sialometadysplasia *Necrotizing sialometadysplasia The etiology of necrotizing sialometadysplasia is
unknown
.
It is generally believed that infarct necrotic inflammation occurs due to ischemia
.
It is more common in the palate, especially at the junction of the hard and soft palate (90%)-crater-like ulcer, which is clearly separated from the surrounding area
.
There is granulation tissue on the surface of the ulcer with a raised edge
.
The ulcers are 1-3cm in diameter and usually heal within 4-10 months
.
The ulcer can reach the bone surface, but there is no bone destruction in X-ray
.

 

*Wright syndrome

* Wright syndrome * Wright syndrome

Wright’s syndrome refers to an inflammatory disease that has the triad of arthritis, urethritis and conjunctivitis, and can be accompanied by oral ulcers and purulent skin keratosis.
It can manifest as superficial oral ulcers, initially blisters, Gradually develop into superficial, mostly painless
.

Wright’s syndrome refers to an inflammatory disease that has the triad of arthritis, urethritis and conjunctivitis, and can be accompanied by oral ulcers and purulent skin keratosis.
It can manifest as superficial oral ulcers, initially blisters, Gradually develop into superficial, mostly painless
.

 

  

*Inflammatory bowel disease

*Inflammatory bowel disease *Inflammatory bowel disease

Oral ulcers in ulcerative colitis (UC) have no characteristics
.

Oral ulcers in ulcerative colitis (UC) have no characteristics
.

Crohn disease (CD) oral ulcers are more common, and in addition to RAS manifestations, it can also have painful oral ulcers and gum ulcers
.

Crohn disease (CD) oral ulcers are more common, and in addition to RAS manifestations, it can also have painful oral ulcers and gum ulcers
.

 

*Systemic lupus erythematosus

*Systemic lupus erythematosus *Systemic lupus erythematosus

The mucosal damage of SLE mainly manifests as oral ulcers.
The typical lesions are small spots on the buccal mucosa, gums, palate and other parts, which gradually develop into superficial painful ulcers.
Other parts such as the nasal septal mucosa and the perineal mucosa can also appear ulcers
.

The mucosal damage of SLE mainly manifests as oral ulcers.
The typical lesions are small spots on the buccal mucosa, gums, palate and other parts, which gradually develop into superficial painful ulcers.
Other parts such as the nasal septal mucosa and the perineal mucosa can also appear ulcers
.

 

*PFAPA (cycle fever-aphthous stomatitis-pharyngitis-lymphadenitis)

*PFAPA (cycle fever-aphthous stomatitis-pharyngitis-lymphadenitis) *PFAPA (cycle fever-aphthous stomatitis-pharyngitis-lymphadenitis)

It manifests as periodic fever with oral ulcers, pharyngitis and lymphadenitis, and its recurrence pattern is about once a month
.

It manifests as periodic fever with oral ulcers, pharyngitis and lymphadenitis, and its recurrence pattern is about once a month
.

 

* Behcet's disease

* Behcet's disease * Behcet's disease

Recurrent oral ulcers are most common in Behcet's disease
.
Behcet's disease is a disease whose main clinical symptoms are the triad of oral ulcers, vulvar ulcers, and ocular lesions
.
In addition, Behcet's disease may also involve the digestive tract and form ulcers in various parts of the digestive tract.
Digestive ulcers with bleeding and perforation are important reasons for the poor prognosis of Behcet's disease
.

Recurrent oral ulcers are most common in Behcet's disease
.
Behcet's disease is a disease whose main clinical symptoms are the triad of oral ulcers, vulvar ulcers, and ocular lesions
.
In addition, Behcet's disease may also involve the digestive tract and form ulcers in various parts of the digestive tract.
Digestive ulcers with bleeding and perforation are important reasons for the poor prognosis of Behcet's disease
.

 

*Sjogren's syndrome

*Sjogren's syndrome * Sjogren's syndrome

Sjogren’s syndrome is a chronic autoimmune disease that invades exocrine glands, especially salivary glands and lacrimal glands.
Patients will have recurrent painful oral ulcers, accompanied by severe dry mouth and eyes
.
Symptoms may also be affected by other exocrine glands, and other organs outside the emergence of multi-system damage, such as associated with pulmonary fibrosis, anemia, leukopenia, renal tubular acidosis, purpura
.

Sjogren’s syndrome is a chronic autoimmune disease that invades exocrine glands, especially salivary glands and lacrimal glands.
Patients will have recurrent painful oral ulcers, accompanied by severe dry mouth and eyes
.
Symptoms may also be affected by other exocrine glands, and other organs outside the emergence of multi-system damage, such as associated with pulmonary fibrosis, anemia, leukopenia, renal tubular acidosis, purpura
.

 

*A20 single dose is insufficient

*Insufficient single dose of A20* Insufficient single dose of A20

The clinical phenotype of HA20 is variable and covers a variety of manifestations of autoimmune diseases and autoinflammatory diseases
.
Therefore, it is necessary for clinicians to have sufficient awareness of screening before genetic diagnosis
.
Like Behcet’s disease, the clinical manifestations of HA20 can include oral ulcers, genital ulcers, pseudofolliculitis-like, erythema nodosum and other rashes, binocular uveitis, and changes in central nervous system vasculitis
.

The clinical phenotype of HA20 is variable and covers a variety of manifestations of autoimmune diseases and autoinflammatory diseases
.
Therefore, it is necessary for clinicians to have sufficient awareness of screening before genetic diagnosis
.
Like Behcet’s disease, the clinical manifestations of HA20 can include oral ulcers, genital ulcers, pseudofolliculitis-like, erythema nodosum and other rashes, binocular uveitis, and changes in central nervous system vasculitis
.

 

*Periodic agranulocytosis

*Cyclic agranulocytosis *Cyclic agranulocytosis

At the same time as agranulocytosis, it can be accompanied by oral ulcers, fever, pharyngitis, dysphagia, and sepsis
.

At the same time as agranulocytosis, it can be accompanied by oral ulcers, fever, pharyngitis, dysphagia, and sepsis
.

 

*High immunoglobulin D syndrome

*High immunoglobulin D syndrome *High immunoglobulin D syndrome

A rare autosomal recessive genetic disease characterized by repeated fever
.
Some patients may have oral ulcers or genital ulcers
.

A rare autosomal recessive genetic disease characterized by repeated fever
.
Some patients may have oral ulcers or genital ulcers
.

 

*Malignant ulcer (malignant ulcer)

*Malignant ulcer (malignant ulcer) malignant ulcer * malignant ulcer (malignant ulcer)

Malignant tumors can occur in any part of the oral mucosa
.
Common tongue cancer, buccal cancer, soft palate cancer, malignant granuloma and so on
.
*Other diseases that cause oral ulcers

Malignant tumors can occur in any part of the oral mucosa
.
Common tongue cancer, buccal cancer, soft palate cancer, malignant granuloma and so on
.
*Other diseases that cause oral ulcers

In fact, many diseases can cause oral ulcer-like lesions
.
For example, tuberculosis, syphilis, AIDS, Yersinia infection, typhoid, paratyphoid
.

In fact, many diseases can cause oral ulcer-like lesions
.
For example, tuberculosis, syphilis, AIDS, Yersinia infection, typhoid, paratyphoid
.

 

 

It can be seen that the appearance of ulcers on the oral mucosa can be a common manifestation of many diseases, which requires analysis and differential diagnosis based on medical history, clinical manifestations and a series of examinations
.
On the premise of multidisciplinary comprehensive diagnosis and treatment, reasonable diagnosis and treatment recommendations should be given for systemic diseases that cause oral ulcers, so that early diagnosis and early treatment can be achieved, so as to improve the prognosis
.

It can be seen that the appearance of ulcers on the oral mucosa can be a common manifestation of many diseases, which requires analysis and differential diagnosis based on medical history, clinical manifestations and a series of examinations
.
The appearance of ulcers on the oral mucosa can be a common manifestation of many diseases, which requires analysis and differential diagnosis based on medical history, clinical manifestations and a series of examinations
.
On the premise of multidisciplinary comprehensive diagnosis and treatment, reasonable diagnosis and treatment recommendations should be
given for systemic diseases that cause oral ulcers, so that early diagnosis and early treatment can be achieved, so as to improve the prognosis .
Achieve early diagnosis and early treatment, thereby improving the prognosis
.

 

References: [1] FatahzadehM.
Recurrentoral herpes:diagnosis & management.
JNJ Dent Assoc,2012,83(4):24-26.

References: [1] FatahzadehM.
Recurrentoral herpes:diagnosis & management.
JNJ Dent Assoc,2012,83(4):24-26.

[2] Oral Mucosal Disease Professional Committee of Chinese Stomatological Association, Chinese Stomatological Association Professional Committee of Integrated Traditional Chinese and Western Medicine, Zhou Gang.
Guidelines for the diagnosis and treatment of recurrent aphthous ulcers (trial implementation)[J].
Chinese Journal of Stomatology, 2012, 47( 7): 402-404.

[2] Oral Mucosal Disease Professional Committee of Chinese Stomatological Association, Chinese Stomatological Association Professional Committee of Integrated Traditional Chinese and Western Medicine, Zhou Gang.
Guidelines for the diagnosis and treatment of recurrent aphthous ulcers (trial implementation)[J].
Chinese Journal of Stomatology, 2012, 47( 7): 402-404.

[3] Siu A, Landon K, Ramos DM.
Differential diagnosis and management of oral ulcers.
[J].
Seminars in Cutaneous Medicine & Surgery,2015, 34(4):171.
 

[3] Siu A, Landon K, Ramos DM.
Differential diagnosis and management of oral ulcers.
[J].
Seminars in Cutaneous Medicine & Surgery,2015, 34(4):171.
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