STUDY - Technical - New Dacian's Medicine
Diseases
of the Oral Mucosa (1)
Translation Draft
These conditions are infections, pigmentation lesions, dermatological diseases, tongue disorders, halitosis, HIV disease and AIDS.
Because the documentation to which I have access is not very "cursive" and because I am going through a period with too little time available (a long time, until around July 1, of "hey-rup" at work) I will proceed to a rather telegramic passage over many of what I will present.
I'll start with infections in the oral mucosa, produced in the vast majority of microorganisms. The first medical "category" That I will address is the vesicular, bullous or ulcerative lesions of the mucosa of the oral cavity. These are caused by viral, bacterial or fungal diseases, dermatological and other conditions.
Viral diseases manifest themselves mainly due to herpes viruses and have several forms. Acute primary herpetic gingivostomatitis (caused by the action of herpes simplex virus type 1, rarely type 2) has a frequent localization of manifestations in the lips and oral mucosa and occurs mainly in infants, children and young adults.
The manifestations are represented by labial vesicles that break and form crusts and intrabucal vesicles that quickly ulcerate, being extremely painful. It also causes acute gingivitis, fever, malaise, fetid halena and cervical adenopathy. It heals spontaneously in 10-14 days, if it does not overinfect. Recurrent labial herpes is localized at the mucocutaneous junction of the lip and at the level of the perioral skin.
It is manifested by eruptions of clustered vesicles that can fuse, then break and form crusts, painful under pressure or on spicy foods. It takes about a week, but can be prolonged if overinfection occurs. Recurrent intrabucal simplex herpes is localized in the palate and gum and manifested by small blisters that break and fuse, often being painful. It heals spontaneously in about a week.
Wind spilled (caused by the varicella-zoster virus) is manifested in the gum and oral mucosa through skin lesions that can be accompanied by small blisters on the oral mucosa that break and form superficial ulcers, can merge forming large bullous lesions that ulcerate and the mucosa can present generalized erythema. The lesions heal spontaneously within two weeks.
Herpes zoster (reactivation of the varicella-zoster virus) is manifested in the cheek, tongue, gum or palate through a unilateral vesicular rash and linear trajectory ulceration following the sensory distribution of the trigeminal nerve or one of its branches. Healing is gradual without scarring and postherpetic neuralgia is common.
Infectious mononucleosis is caused by the Epstein-Barr virus and is localized in the oral mucosa. Manifestations are represented by asthenia, neck pain, malaise, subfebrillity and cervical adenopathy. Numerous small ulcers usually occur a few days before adenopathy, as well as gum bleeding and multiple spots at the junction between the rough and soft palates. Oral lesions disappear during convalescence. Warts, due to the papilloma virus, appear anywhere on the skin and oral mucosa. It is manifested by single or multiple papillary lesions with thick, white keratinized surfaces with numerous punctual protrusions, as well as conopidoform lesions covered by normally colored mucosa or multiple pink or pale protrusions (focal epithelial hyperplasia). From an evolutionary point of view there are no clear elements but the lesions grow rapidly and spread.
Herpangina caused by the coxsackie A virus, also possible and form B and echovirus, has manifestations in the oral mucosa, pharynx and tongue. The onset is sudden with fever, sore throat and oropharyngeal vesicles, usually in children under 4 years of age during the summer months. Diffuse pharyngeal congestion and blisters (1-2 mm) of white-grey color surrounded by red areolas also occur and the vesicles grow and ulcerate. The incubation period is 2-9 days, fever manifests itself for 1-4 days and healing occurs without incident.
Another manifestation of coxsackia type A viruses is the hand, foot and mouth disease and is present in the oral mucosa, pharynx, palms and plants. It is manifested by fever, malaise, headache with oropharyngeal vesicles that turn into painful superficial ulcers. The incubation period is 8-12 days and the lesions heal spontaneously in 2-4 weeks. There is something else to be said for primary HIV infection and it has manifestations in the gum, palate and pharynx through acute gingivitis and oropharyngeal ulcerations, associated with a febrile mononucleosis-like disease that also includes adenopathy. It is followed by HIV seroconversion, asymptomatic HIV infection and usually, ultimately, HIV disease.
It's the turn of bacterial or fungal diseases. I will start with acute ulcero-necrotic gingivitis ("mouth with grooves" or Vincent infection) which manifests itself in the gum through ulcerative, bleeding gum, characterized by necrosis and ulceration of the papillae and gum edges, plus adenopathy and fetid halena. The disease progresses to tissue destruction followed by remission and possible recurrences.
Syphilis has several oral "manifestations". Prenatal (congenital) syphilis is manifested in the palate, jaws, tongue and teeth through gomous lesions of the palate, jaw and facial bones, Hutchinson incisors, mulberry-like molars, glossitis, mucous spots and ragades at the mouth. There is no question of an evolution only that dental deformities in the permanent teeth are irreversible.
Primary syphilis has lesions that occur at the entrance gate and is often present on the lips, tongue or in the amygdala area. It is manifested by small papules that quickly turn into a large, painless ulceration with hard edges, unilateral lymphadenopathy. The sham and lymph nodes contain spirochetes, serological tests being positive after 3-4 weeks. Evolutionaryly, the sham is cured in 1-2 months, followed by the appearance of secondary syphilis after 6-8 weeks.
In the case of secondary syphilis, the oral mucosa is frequently affected, with mucous spots, especially on the palate, but also in the oral commisions. It highlights maculopapular lesions of the oral mucosa, with a diameter of 5-10 mm, with central ulceration covered by a gray membrane. Eruptions occur on different mucous and skin surfaces, accompanied by fever, malaise and sore throat. Evolutionaryly, lesions can persist from a few weeks to a year.
Tertiary syphilis often has manifestations in the palate and tongue through gomous infiltrations of the palate or tongue, followed by ulceration and fibrosis. Lingual papillary atrophy produces characteristic depapillary tongue and glossitis. Evolutionary goms can destroy the palate causing complete perforation.
Gonorrhea is also manifested by lesions that may occur in the oral cavity at the site of inoculation or secondary, by hematogenous dissemination from the level of a primary outbreak located at a distance. The earliest symptoms are burning or itching sensations, dryness or heat in the oral cavity, followed by acute pain in eating or speech. The tonsils and oropharynx are most commonly involved.
Oral tissues can be diffusely inflamed or ulcerated, increased viscosity of saliva and fetid halena as well as submandibular adenopathy with fever are noted in severe cases. Injuries may be remitted under appropriate antibiotic treatment. Another source of oral problems is tuberculosis with manifestations in the tongue, tonsil region and soft palate, fleshed out in solitary, irregular ulcer, with firm edges, covered by persistent exudate. Evolutionary lesions can persist.
Another "source" is cervicofacial actinomicosis with swelling in the region of the face, neck and oral floor. The infection may be associated with extraction, jaw fracture or molar eruption in the acute form resembling an acute pyogenic abscess, but contains yellow "sulphur granules" (gram positive mice and their hyphes). From an evolutionary point of view, the acute form can last several weeks, the chronic form lasting months or years, but the prognosis is excellent. Actinomics respond to antibiotics (tetracycline or penicillin) but not to antimycotics.
A more serious condition is histoplasmosis. It can have manifestations in any area in the oral cavity, especially the tongue, gum and/ or palate. It is manifested by numerous small nodules that can ulcerate, dysphonia and dysphagia can occur due to lesions in the larynx and are usually associated with fever and malaise. Evolutionaryly, this condition can be fatal.
A last condition with oral manifestation (from this post) would be candidiasis affecting any area of the oral mucosa. It has several forms of manifestation: 1. the psedomembranous form presents white spots that can be easily removed, leaving a red, bleeding, painful surface, 2. the erythematous form presents red flat spots, 3. rarely, candidosis leukoplasia presents as a white lingual stain that is not erased, 4. in the angular cheilitis produced by Candida appear painful cracks and erythema in the candida is observed on KOH preparations in all forms. Evolutionaryly everything is OK because it responds to antimycotics.
We still have plenty to present here, but not today. So, see you tomorrow!
These conditions are infections, pigmentation lesions, dermatological diseases, tongue disorders, halitosis, HIV disease and AIDS.
Because the documentation to which I have access is not very "cursive" and because I am going through a period with too little time available (a long time, until around July 1, of "hey-rup" at work) I will proceed to a rather telegramic passage over many of what I will present.
I'll start with infections in the oral mucosa, produced in the vast majority of microorganisms. The first medical "category" That I will address is the vesicular, bullous or ulcerative lesions of the mucosa of the oral cavity. These are caused by viral, bacterial or fungal diseases, dermatological and other conditions.
Viral diseases manifest themselves mainly due to herpes viruses and have several forms. Acute primary herpetic gingivostomatitis (caused by the action of herpes simplex virus type 1, rarely type 2) has a frequent localization of manifestations in the lips and oral mucosa and occurs mainly in infants, children and young adults.
The manifestations are represented by labial vesicles that break and form crusts and intrabucal vesicles that quickly ulcerate, being extremely painful. It also causes acute gingivitis, fever, malaise, fetid halena and cervical adenopathy. It heals spontaneously in 10-14 days, if it does not overinfect. Recurrent labial herpes is localized at the mucocutaneous junction of the lip and at the level of the perioral skin.
It is manifested by eruptions of clustered vesicles that can fuse, then break and form crusts, painful under pressure or on spicy foods. It takes about a week, but can be prolonged if overinfection occurs. Recurrent intrabucal simplex herpes is localized in the palate and gum and manifested by small blisters that break and fuse, often being painful. It heals spontaneously in about a week.
Wind spilled (caused by the varicella-zoster virus) is manifested in the gum and oral mucosa through skin lesions that can be accompanied by small blisters on the oral mucosa that break and form superficial ulcers, can merge forming large bullous lesions that ulcerate and the mucosa can present generalized erythema. The lesions heal spontaneously within two weeks.
Herpes zoster (reactivation of the varicella-zoster virus) is manifested in the cheek, tongue, gum or palate through a unilateral vesicular rash and linear trajectory ulceration following the sensory distribution of the trigeminal nerve or one of its branches. Healing is gradual without scarring and postherpetic neuralgia is common.
Infectious mononucleosis is caused by the Epstein-Barr virus and is localized in the oral mucosa. Manifestations are represented by asthenia, neck pain, malaise, subfebrillity and cervical adenopathy. Numerous small ulcers usually occur a few days before adenopathy, as well as gum bleeding and multiple spots at the junction between the rough and soft palates. Oral lesions disappear during convalescence. Warts, due to the papilloma virus, appear anywhere on the skin and oral mucosa. It is manifested by single or multiple papillary lesions with thick, white keratinized surfaces with numerous punctual protrusions, as well as conopidoform lesions covered by normally colored mucosa or multiple pink or pale protrusions (focal epithelial hyperplasia). From an evolutionary point of view there are no clear elements but the lesions grow rapidly and spread.
Herpangina caused by the coxsackie A virus, also possible and form B and echovirus, has manifestations in the oral mucosa, pharynx and tongue. The onset is sudden with fever, sore throat and oropharyngeal vesicles, usually in children under 4 years of age during the summer months. Diffuse pharyngeal congestion and blisters (1-2 mm) of white-grey color surrounded by red areolas also occur and the vesicles grow and ulcerate. The incubation period is 2-9 days, fever manifests itself for 1-4 days and healing occurs without incident.
Another manifestation of coxsackia type A viruses is the hand, foot and mouth disease and is present in the oral mucosa, pharynx, palms and plants. It is manifested by fever, malaise, headache with oropharyngeal vesicles that turn into painful superficial ulcers. The incubation period is 8-12 days and the lesions heal spontaneously in 2-4 weeks. There is something else to be said for primary HIV infection and it has manifestations in the gum, palate and pharynx through acute gingivitis and oropharyngeal ulcerations, associated with a febrile mononucleosis-like disease that also includes adenopathy. It is followed by HIV seroconversion, asymptomatic HIV infection and usually, ultimately, HIV disease.
It's the turn of bacterial or fungal diseases. I will start with acute ulcero-necrotic gingivitis ("mouth with grooves" or Vincent infection) which manifests itself in the gum through ulcerative, bleeding gum, characterized by necrosis and ulceration of the papillae and gum edges, plus adenopathy and fetid halena. The disease progresses to tissue destruction followed by remission and possible recurrences.
Syphilis has several oral "manifestations". Prenatal (congenital) syphilis is manifested in the palate, jaws, tongue and teeth through gomous lesions of the palate, jaw and facial bones, Hutchinson incisors, mulberry-like molars, glossitis, mucous spots and ragades at the mouth. There is no question of an evolution only that dental deformities in the permanent teeth are irreversible.
Primary syphilis has lesions that occur at the entrance gate and is often present on the lips, tongue or in the amygdala area. It is manifested by small papules that quickly turn into a large, painless ulceration with hard edges, unilateral lymphadenopathy. The sham and lymph nodes contain spirochetes, serological tests being positive after 3-4 weeks. Evolutionaryly, the sham is cured in 1-2 months, followed by the appearance of secondary syphilis after 6-8 weeks.
In the case of secondary syphilis, the oral mucosa is frequently affected, with mucous spots, especially on the palate, but also in the oral commisions. It highlights maculopapular lesions of the oral mucosa, with a diameter of 5-10 mm, with central ulceration covered by a gray membrane. Eruptions occur on different mucous and skin surfaces, accompanied by fever, malaise and sore throat. Evolutionaryly, lesions can persist from a few weeks to a year.
Tertiary syphilis often has manifestations in the palate and tongue through gomous infiltrations of the palate or tongue, followed by ulceration and fibrosis. Lingual papillary atrophy produces characteristic depapillary tongue and glossitis. Evolutionary goms can destroy the palate causing complete perforation.
Gonorrhea is also manifested by lesions that may occur in the oral cavity at the site of inoculation or secondary, by hematogenous dissemination from the level of a primary outbreak located at a distance. The earliest symptoms are burning or itching sensations, dryness or heat in the oral cavity, followed by acute pain in eating or speech. The tonsils and oropharynx are most commonly involved.
Oral tissues can be diffusely inflamed or ulcerated, increased viscosity of saliva and fetid halena as well as submandibular adenopathy with fever are noted in severe cases. Injuries may be remitted under appropriate antibiotic treatment. Another source of oral problems is tuberculosis with manifestations in the tongue, tonsil region and soft palate, fleshed out in solitary, irregular ulcer, with firm edges, covered by persistent exudate. Evolutionary lesions can persist.
Another "source" is cervicofacial actinomicosis with swelling in the region of the face, neck and oral floor. The infection may be associated with extraction, jaw fracture or molar eruption in the acute form resembling an acute pyogenic abscess, but contains yellow "sulphur granules" (gram positive mice and their hyphes). From an evolutionary point of view, the acute form can last several weeks, the chronic form lasting months or years, but the prognosis is excellent. Actinomics respond to antibiotics (tetracycline or penicillin) but not to antimycotics.
A more serious condition is histoplasmosis. It can have manifestations in any area in the oral cavity, especially the tongue, gum and/ or palate. It is manifested by numerous small nodules that can ulcerate, dysphonia and dysphagia can occur due to lesions in the larynx and are usually associated with fever and malaise. Evolutionaryly, this condition can be fatal.
A last condition with oral manifestation (from this post) would be candidiasis affecting any area of the oral mucosa. It has several forms of manifestation: 1. the psedomembranous form presents white spots that can be easily removed, leaving a red, bleeding, painful surface, 2. the erythematous form presents red flat spots, 3. rarely, candidosis leukoplasia presents as a white lingual stain that is not erased, 4. in the angular cheilitis produced by Candida appear painful cracks and erythema in the candida is observed on KOH preparations in all forms. Evolutionaryly everything is OK because it responds to antimycotics.
We still have plenty to present here, but not today. So, see you tomorrow!
Have a good day!
Dorin, Merticaru