Stomatitis differential diagnosis: Difference between revisions
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*Physical exam | *Physical exam | ||
*Biopsy | |||
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*Oral Cavity | *Oral Cavity | ||
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*Can spread to [[TMJ]] | *Can spread to [[TMJ]] | ||
*Some times associated with [[leukoplakia]] | *Some times associated with [[leukoplakia]] | ||
|[[File:Squamous cell carcinoma.jpg|Squamous cell carcinoma| | |[[File:Squamous cell carcinoma.jpg|Squamous cell carcinoma|500px]] | ||
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|[[Leukoplakia]] | |[[Leukoplakia]] | ||
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*Physical exam | *Physical exam | ||
*Diagnosis of exclusion | *Diagnosis of exclusion | ||
*Biopsy | |||
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*Vulvar lesions occur independent of oral lesions | *Vulvar lesions occur independent of oral lesions | ||
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*Associated with [[HIV]] | *Associated with [[HIV]] | ||
*Persistant white spots | *Persistant white spots | ||
|[[File:Oral hairy leukoplakia (EBV, in HIV).jpg|Leukoplakia| | |[[File:Oral hairy leukoplakia (EBV, in HIV).jpg|Leukoplakia|500px]] | ||
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|[[Melanoma]] | |[[Melanoma]] | ||
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*ABCD characteristics | *ABCD characteristics | ||
*[[Bleeding]] or [[ulceration]] may show [[malignancy]] | *[[Bleeding]] or [[ulceration]] may show [[malignancy]] | ||
* Serum [[LDH]] may be elevated in case of [[malignancy]] | *Serum [[LDH]] may be elevated in case of [[malignancy]] | ||
*Biopsy | |||
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*Can metastasize | *Can metastasize | ||
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*Progression involves [[MAPK/ERK pathway]] | *Progression involves [[MAPK/ERK pathway]] | ||
*[[N-RAS]] or [[BRAF]] oncogene also involved | *[[N-RAS]] or [[BRAF]] oncogene also involved | ||
|[[File:Melanoma oral 001.jpg|Oral melanoma| | |[[File:Melanoma oral 001.jpg|Oral melanoma|500px]] | ||
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|[[Fordyce spots]] | |[[Fordyce spots]] | ||
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*No surrounding mucosal change | *No surrounding mucosal change | ||
*Several adjacent glands may coalesce into a larger cauliflower-like cluster | *Several adjacent glands may coalesce into a larger cauliflower-like cluster | ||
|[[File:Fordyce spots 02.jpeg|Fordyce spots| | |[[File:Fordyce spots 02.jpeg|Fordyce spots|500px]] | ||
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|[[Burning mouth syndrome]] | |||
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*[[Burning]] or [[tingling]] on the [[lips]], [[tongue]], or entire [[mouth]] | |||
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*Nutritional deficiencies | |||
*Chronic [[anxiety]] or [[depression] | |||
*Type 2 diabetes | |||
*Menopause | |||
*Oral thrush or dry mouth, or damaged taste nerves | |||
*Female gender | |||
*Menopause | |||
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*Presentation | |||
*Physical exam | |||
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*Oral cavity | |||
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*Pain typically is low in the morning and builds up over the day | |||
*Low dosages of [[benzodiazepines]], [[tricyclic antidepressants]] or [[anticonvulsants]] may be effective | |||
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|[[Torus palatinus]] | |[[Torus palatinus]] | ||
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**Lobular tori | **Lobular tori | ||
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* | *Hard palate | ||
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*More common in Asian and Inuit populations | *More common in Asian and Inuit populations | ||
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*Repeated trauma can cause bleeding | *Repeated trauma can cause bleeding | ||
*Surgery may be required in symptomatic | *Surgery may be required in symptomatic | ||
|[[File:06-06-06palataltori.jpg|Torus palatinus| | |[[File:06-06-06palataltori.jpg|Torus palatinus|500px]] | ||
|- | |- | ||
| colspan="4" |'''Diseases involving oral cavity and other organ systems''' | | colspan="4" |'''Diseases involving oral cavity and other organ systems''' | ||
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*Outbreaks of exaggerated inflammation | *Outbreaks of exaggerated inflammation | ||
*Affects smaller blood vessels | *Affects smaller blood vessels | ||
|[[File:Behcet's syndrome 11.jpeg|Behcet's disease| | |[[File:Behcet's syndrome 11.jpeg|Behcet's disease|500px]] | ||
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|[[Crohn's disease]] | |[[Crohn's disease]] | ||
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**Malignant | **Malignant | ||
**Autoimmune | **Autoimmune | ||
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**Gummas | **Gummas | ||
**Neurosyphilis | **Neurosyphilis | ||
|[[File:Syphilis oral.jpg|oral syphilis| | |[[File:Syphilis oral.jpg|oral syphilis|500px]] | ||
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|[[Coxsackie virus]] | |[[Coxsackie virus]] | ||
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*Symptomatic treatment | *Symptomatic treatment | ||
|[[File:Hand foot mouth disease 07.jpeg|Hand-foot-and-mouth disease| | |[[File:Hand foot mouth disease 07.jpeg|Hand-foot-and-mouth disease|500px]] | ||
|- | |- | ||
|[[Chickenpox|Chicken pox]] | |[[Chickenpox|Chicken pox]] | ||
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*Paracetamol (acetaminophen) for fever | *Paracetamol (acetaminophen) for fever | ||
*[[Prednisolone]] is contraindicated | *[[Prednisolone]] is contraindicated | ||
|[[File:Chickenpox18.jpeg|Chickenpox| | |[[File:Chickenpox18.jpeg|Chickenpox|500px]] | ||
|- | |- | ||
|[[Measles]] | |[[Measles]] | ||
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*Primary site of infection is the respiratory epithelium of the nasopharynx | *Primary site of infection is the respiratory epithelium of the nasopharynx | ||
*Transmitted in respiratory secretions, via aerosol droplets containing virus particles | *Transmitted in respiratory secretions, via aerosol droplets containing virus particles | ||
|[[File:Koplikspot1.jpg|Koplick spots (Measles)| | |[[File:Koplikspot1.jpg|Koplick spots (Measles)|500px]] | ||
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Revision as of 12:45, 16 March 2017
Stomatitis Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Stomatitis differential diagnosis On the Web |
American Roentgen Ray Society Images of Stomatitis differential diagnosis |
Risk calculators and risk factors for Stomatitis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Stomatitis should be differentiated from various subtypes of stomatitis and from many other disease that can involve the oral cavity such as agranulocystosis, Behcet's disease, immunodeficiency and tutors of the oral cavity like leukoplakia etc.[1][2]
Differential diagnosis
Stomatitis must be differentiated from its different kinds and from various other disease that can mimic stomatitis or have accompanying features involving other organs.
Disease | Presentation | Risk Factors | Diagnosis | Systemic Involvement | Important features | Picture |
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Diseases predominantly affecting the oral cavity | ||||||
Squamous cell carcinoma |
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Leukoplakia |
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Melanoma |
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Fordyce spots |
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Burning mouth syndrome |
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Torus palatinus |
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Diseases involving oral cavity and other organ systems | ||||||
Behcet's disease |
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Crohn's disease |
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Agranulocytosis |
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Syphilis[4] |
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Coxsackie virus |
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Chicken pox |
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Measles |
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Stomatitis should be differentiated from other disease as well as from possible underlying conditions causing stomatitis including:[1][2]
- Tumors of the tongue
- Squamous cell carcinoma
- It can prevent as a non healing ulcer or as a mass and is mostly caused by smoking or alcohol utilization.[7]
- Leukoplakia
- Melanoma
- It has the typical abcde characteristics including asymmetry, irregular borders, color change, increase in diameter and evolution and is usually diagnosed in its later stages.[10]
- Fordyce spots
- These are benign neoplasms with sebaceous features
- Torrus Palatinus
- It is a nodular mass on the hard palate, covered with normal mucosa[11]
- Squamous cell carcinoma
- Autoimmune diseases[12]
- Behcet's syndrome[13]
- Crohn's disease
- Agranulocytosis
- Nicorandil induced ulcers
- It is a drug use in angina pectoris
- Burning mouth syndrome
- It is characterized by constant sensation of burning in the mouth in post menopausal women.
- There is no particular cause for it and no specific treatment is done.
- Syphilis
- Coxsackie virus accompanies involvement of the hands and the mouth
- HIV
- VZV or Chicken pox
References
- ↑ 1.0 1.1 Mandell; Gouglas, Gordon; Bennett, John. Principles and Practice of Infectious Diseases. Harvard Medical School: WILEY MEDICAL. p. 383. ISBN 0-471-87643-7. Unknown parameter
|firs1t=
ignored (help) - ↑ 2.0 2.1 Scully C (1999). "A review of common mucocutaneous disorders affecting the mouth and lips". Ann Acad Med Singapore. 28 (5): 704–7. PMID 10597357.
- ↑ Andrès E, Zimmer J, Affenberger S, Federici L, Alt M, Maloisel F. (2006). "Idiosyncratic drug-induced agranulocytosis: Update of an old disorder". Eur J Intern Med. 17 (8): 529–35. Text "pmid 17142169" ignored (help)
- ↑ title="By Internet Archive Book Images [No restrictions], via Wikimedia Commons" href="https://commons.wikimedia.org/wiki/File%3AA_manual_of_syphilis_and_the_venereal_diseases%2C_(1900)_(14595882378).jpg"
- ↑ Feikin DR, Lezotte DC, Hamman RF, Salmon DA, Chen RT, Hoffman RE (2000). "Individual and community risks of measles and pertussis associated with personal exemptions to immunization". JAMA. 284 (24): 3145–50. PMID 11135778.
- ↑ Ratnam S, West R, Gadag V, Williams B, Oates E (1996). "Immunity against measles in school-aged children: implications for measles revaccination strategies". Can J Public Health. 87 (6): 407–10. PMID 9009400.
- ↑ R. Morgan, J. Tsang, N. Harrington & L. Fook (2001). "Survey of hospital doctors' attitudes and knowledge of oral conditions in older patients". Postgraduate medical journal. 77 (908): 392–394. PMID 11375454. Unknown parameter
|month=
ignored (help) - ↑ D. Grady, J. Greene, T. E. Daniels, V. L. Ernster, P. B. Robertson, W. Hauck, D. Greenspan, J. Greenspan & S. Jr Silverman (1990). "Oral mucosal lesions found in smokeless tobacco users". Journal of the American Dental Association (1939). 121 (1): 117–123. PMID 2370378. Unknown parameter
|month=
ignored (help) - ↑ Ann M. Gillenwater, Nadarajah Vigneswaran, Hanadi Fatani, Pierre Saintigny & Adel K. El-Naggar (2013). "Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity!". Advances in anatomic pathology. 20 (6): 416–423. doi:10.1097/PAP.0b013e3182a92df1. PMID 24113312. Unknown parameter
|month=
ignored (help) - ↑ P. DeMatos, D. S. Tyler & H. F. Seigler (1998). "Malignant melanoma of the mucous membranes: a review of 119 cases". Annals of surgical oncology. 5 (8): 733–742. PMID 9869521. Unknown parameter
|month=
ignored (help) - ↑ Barry Ladizinski & Kachiu C. Lee (2014). "A nodular protuberance on the hard palate". JAMA. 311 (15): 1558–1559. doi:10.1001/jama.2014.271. PMID 24737369. Unknown parameter
|month=
ignored (help) - ↑ Magliocca KR, Fitzpatrick SG (2017) Autoimmune Disease Manifestations in the Oral Cavity. Surg Pathol Clin 10 (1):57-88. DOI:10.1016/j.path.2016.11.001 PMID: 28153136
- ↑ Dalghous AM, Freysdottir J, Fortune F (2006). "Expression of cytokines, chemokines, and chemokine receptors in oral ulcers of patients with Behcet's disease (BD) and recurrent aphthous stomatitis is Th1-associated, although Th2-association is also observed in patients with BD". Scand J Rheumatol. 35 (6): 472–5. PMID 17343257.