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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,NEXT,口腔粘膜溃疡类疾病,Oral Ulcerative diseases,BACK TO INDEX,NEXT口腔粘膜溃疡类疾病Oral Ulcerative d,Introduction,Beh?ets disease,Traumatic Ulcer & Traumatic Bulla,Recurrent Aphthous Ulcer,Summary & Questions,BACK,Reiters Syndrome,IntroductionBeh?ets diseaseTr,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,I. Introduction1.Ulcers are on,ulcer,erosion,NEXT,ulcererosionNEXT,ulcer,erosion,continuity of,epithelium,broken,severe,superficial,basal cells,involved,free,border,clear,unclear,diseases,RAU,Behcets disease,Syphilis,Pemphigus,Herpes simplex,BACK,Comparison,ulcererosioncontinuity of epit,II.Recurrent Aphthous Ulcer,1.Preface,?,Name,recurrent aphthous ulcer RAU,recurrent aphthous stomatitis RAS,recurrent oral ulcer ROU,NEXT,II.Recurrent Aphthous Ulcer1.P,?,Typing,Lehners classification,minor aphthous ulcer,（,MiAU,）,major aphthous ulcer,（,MjAU,）,herpetiform ulcer,（,HU,）,?,Characteristic,recidivity,self-healing,periodicity,NEXT,?Typing Lehners classifica,2. Etiology,unknown,?,immunity : cellular immunity,humoral immunity, complement,autoantibody,?,heritage,?,infection,：,HSV,?,environment: psychology,NEXT,2. Etiology unknown?immunity,?,denutrition,：,iron, copper, zinc, folic acid,Vit B,12,?,hyperoxide dismutase,?,microcirculation disturbance,：,lip,nail, apex linguae,?,systemic factor,：,ulceration of,stomach,、,hepatitis,、,colonitis,、,diarrhoea,NEXT,?denutrition ：iron, copper, zi,3. Clinical features,minor aphthous ulcer,major aphthous ulcer,herpetiform ulcer,NEXT,3. Clinical featuresminor apht,NEXT,MiAU,MjAU,HU,feature,yellow red concave,painful small (2-,4mm),big (1-3cm),deep scar,multiple small,course,7-10 days,3-6 weeks,7-10 days,number,1-5,1,10,position,nonkeratinized oral,mucosa,soft palate,tongue lip,mouth floor,systemic,symptom,lymph nodes,swelling,fever headache,lymph nodes,swelling,NEXTMiAUMjAUHUfeatureyellow re,Minor,aphthous,ulcers,NEXT,MinoraphthousulcersNEXT,NEXT,NEXT,NEXT,MiAU,MjAU,HU,feature,yellow red concave,painful small (2-,4mm),big (1-3cm),deep scar,multiple small,course,7-10 days,3-6 weeks,7-10 days,number,1-5,1,10,position,nonkeratinized oral,mucosa,soft palate,tongue lip,mouth floor,systemic,symptom,lymph nodes,swelling,fever headache,lymph nodes,swelling,NEXTMiAUMjAUHUfeatureyellow re,Major,aphthous,ulcers,NEXT,Periadenitis Mucosa Necrotica Recurrens,MajoraphthousulcersNEXTPeriade,NEXT,Major,aphthous,ulcers,NEXTMajoraphthousulcers,NEXT,MiAU,MjAU,HU,feature,yellow red concave,painful small (2-,4mm),big (1-3cm),deep scar,multiple small,course,7-10 days,3-6 weeks,7-10 days,number,1-5,1,10,position,nonkeratinized oral,mucosa,soft palate,tongue lip,mouth floor,systemic,symptom,lymph nodes,swelling,fever headache,lymph nodes,swelling,NEXTMiAUMjAUHUfeatureyellow re,Herpetiform,ulcers,NEXT,HerpetiformulcersNEXT,?,disease-process,24h,10d-14d,outbreak,NEXT,intermission,healing,prodromal,stage,ulcerative,stage,?disease-process24h10d-14doutb,5. Diagnosis,?,history,?,clinical feature,NEXT,4. Pathology,：,nonspecific inflammation,5. Diagnosis?history?clinical,6. Differential diagnosis,?,benign ulcer & malignant ulcer,?,Necrotizing sialadenometaplasia,Beh?ets disease, herpes simplex,hand-foot-and-mouth disease,NEXT,6. Differential diagnosis?beni,benign ulcer,malignant ulcer,age,youth,the aged,depth,deep,Deep or shallow,self-healing,yes,no,systemic,condition,good,cachexy,pathology,chronic inflammation,cancer,recurrence,yes,no,Comparison,NEXT,benign ulcermalignant ulcerage,7. Treatment,principle,：,symptomatic treatment,Evaluation of curative effect,NEXT,7. Treatmentprinciple：symptoma,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.,BACK,Topical application of a stero,III. Beh?ets disease,1. Preface,Hulusi Beh?,et (1937),Beh?ets disease is a chronic multisystemic,inflammatory disorder of uncertain cause and,prognosis.,2. Etiology,Unknown,NEXT,III. Beh?ets disease1. Prefac,3. Clinical features,1) oral mucosa,:,minor aphthous ulcer,2) genital lesion:,ulcer,3) skin lesions:,erythema nodosum,epifolliculitis, pustule after needling,4) ocular lesions:,conjunctivitis,recurrent iritis,5) others systems: joint, digestive,cardiovascular, nervous, respiratory, urinary,NEXT,3. Clinical features1) oral mu,Beh?ets disease,NEXT,Beh?ets diseaseNEXT,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,4. Pathology ：Histopathologic,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 Beh?ets Disease,recurrent oral ulceration plus any two of the other,four major clinical criteria must be present.,NEXT,5. Diagnosis1) recurrent oral,6. Differential diagnosis,NEXT,RAU,Herpetic atomatitis,Crohns disease,Reiters syndrome,Stevens-Johnson syndrome,6. Differential diagnosisNEXTR,7. Treatment,Symptomatic in mild cases.,Systemic steroids, immunosuppressive,drugs, colchicines, thalidomide, and,dapsone are administered in severe cases.,BACK,7. Treatment Symptomatic in mi,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.,NEXT,IV. Traumatic Ulcer Traumatic,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.,Physical factors,:,thermal burns,Chemical factors,:,strong acid, strong base,As,2,O,3, Ag(NO),3, iodophenol,NEXT,2. Etiology Mechanical factor,3. Clinical feature,1) Decubital ulcer,?,mechanical irritating factors,?,the ulcer conforms in area and linearity to the,source of the irritating factors,NEXT,3. Clinical feature1) Decubita,NEXT,traumatic ulcer,NEXTtraumatic ulcer,traumatic ulcer,NEXT,traumatic ulcerNEXT,?,infants, hard palate,?,improper feeding,NEXT,2) Bednar ulcer,?infants, hard palate?improper,3) Rida-Fede ulcer,?,infants,?,lingual frenum ulcer secondary to inferior,deciduous incisor,NEXT,3) Rida-Fede ulcer?infants ?li,4) Factitious ulcer,?,mentally handicapped patients or those with,serous emotional problems,?,oral self-inflicted trauma by biting, fingernails,or by the use of a sharp object,?,tongue, lower lip, gingiva,?,slow to heal due to perpetuation of the injury by,the patient,?,local measures and psychiatric therapy,NEXT,4) Factitious ulcer?mentally h,5) Chemical burn,?,the type of chemical utilized, its concentration,and the duration,?,whitish surface,?,desquamating,?,painful erosion,or ulcer,?,bone damage,?,healing within 1-2 weeks,NEXT,5) Chemical burn?the type of c,NEXT,chemical burn,NEXTchemical burn,6) Thermal burn,?,very hot foods, liquid, or hot metal objects,?,palate, lips, floor of the mouth, tongue,?,painful, red, undergoing desquamation, leaving,erosions,?,supportive treatment; self-healing in about a week,NEXT,6) Thermal burn?very hot foods,NEXT,thermal burn,NEXTthermal burn,7) Traumatic bulla & traumatic hematoma,?,caused by biting or prosthetic appliances,?,buccal mucosa, soft palate, lips, tongue,?,self-healing in 4-6 days,NEXT,7) Traumatic bulla & traumatic,traumatic bulla,NEXT,traumatic bullaNEXT,4. Diagnosis,history,clinical features,NEXT,carcinoma, syphilis,tubercular ulcer,major aphthous ulcer,thrombocytopenia, thrombasthenia,pemphigus, cicatricial pemphigoid,5. Differential diagnosis,4. Diagnosis historyclinical f,malignant ulcer,NEXT,malignant ulcerNEXT,Traumatic,ulcer,MjAU,malignant,ulcer,tubercular,ulcer,etiology,feature of,ulcer,morphology,of ulcer,pathology,5. Differential diagnosis,BACK,Traumatic ulcerMjAUmalignant u,6. Treatment,Removal of the traumatic factors,Topical measures,NEXT,6. Treatment Removal of the tr,V,. Reiters Syndrome,1. Preface,Reiters syndrome is a disease of,unknown cause that predominantly,affects young men, 20-30 years of age.,NEXT,2. Etiology,unknown,V. Reiters Syndrome1. Preface,3. Clinical feature,?,Major symptoms: nongonococcal urethritis,conjunctivitis, arthritis,?,Other symptoms: oral ulcer, circinate,balanitis, keratoderma blennorrhagicum,NEXT,3. Clinical feature?Major symp,NEXT,oral lesion,NEXToral lesion,4. Diagnosis,history,clinical criteria,NEXT,4. Diagnosis history clinical,5. Differential diagnosis,The differential diagnosis the oral lesions,includes erythema multiforme, Stevens-,Johnson syndrome, psoriasis, Beh?ets,Disease, geographic tongue, and stomatitis.,NEXT,5. Differential diagnosis The,6. Treatment,It is nonspecific and symptomatic. Non-,steroidal anti-inflammatory drugs,salicylates, and tetracyclines may be helpful,cyclosporin, azathioprine, methotrexate, and,systemic steroid in severe case.,BACK,6. Treatment It is nonspecifi,Summary,1.,To compare the characteristics of major,Aphthous ulcer, traumatic ulcer, carcinoma,and tuberculous ulcer. (etiology, pathology,clinical feature, treatment, prognosis) .,2.,To master the treatment principle of,ulcerative diseases by taking RAU for,example.,NEXT,Summary 1.To compare the chara,3.,To master the effect, usage,contraindication and side-effect of,corticosteroid in treating ulcerative,diseases.,4.,To establish the conception of oral,mucosal syndrome by means of learning,Beh?ets disease.,NEXT,3.To master the effect, usage,Questions,1.,Which is the most common form of,Recurrent Aphthous Ulcer? Whats,the characteristic of its lesion?,2.,Whats the effect of corticosteroid in,treating oral ulcerative diseases?,3.,Whats the primary treatment to,traumatic ulcer?,NEXT,Questions1.Which is the most c,4.,Taking major Aphthous ulcer and,carcinoma for example, try to tell the,difference between benign ulcer and,malignant ulcer.,5.,What are the oral lesions of Beh?ets,Disease and Reiters Syndrome ?,What are their clinical systemic,features?,BACK,4.Taking major Aphthous ulcer,
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