Painful, especially on eating or drinking.One or many lesions scattered throughout the mouth.Does anyone else close to the patient have similar symptoms?.Does the patient have any underlying condition or disease?.Is this a single episode, or have the ulcers occurred before?.What part or parts of the mouth are involved?.Is the ulcer solitary or are there multiple ulcers?.They can also have cutaneous and systemic symptoms and signs.Ī patient with a mouth ulcer should be questioned and examined with a differential diagnosis in mind. Patients may present to doctors or dentists with a mouth ulcer for assessment and treatment.
What are the clinical features of a mouth ulcer? Traumatic mouth ulcers due to ill-fitting dentures Squamous cell carcinoma: invasive cancer and/or in situ leukoplakia (mostly affects smokers)ĭifferential diagnosis includes other inflammatory disorders in which there is no true ulceration, such as migratory glossitis/geographic tongue.Necrotising sialometaplasia: an ischaemic event.Membranous mucositis due to radiation therapy.Eosinophilic ulcer (children or adults).
Blistering skin conditions: especially pemphigus, linear IgA bullous dermatosis, mucous membrane pemphigoid - vesicles that erode/ulcerate may have cutaneous lesions (adults).Orofacial granulomatosis: affects young adults may have swollen lips and other orofacial features.Chronic ulcerative stomatitis: affects middle-aged women.Systemic lupus erythematosus: especially young females.Oral lichen planus: may have cutaneous and mucosal lichen planus at other sites in middle-aged adults.Erythema multiforme major: associated with herpes simplex virus activation in adolescents and young adults.Contact stomatitis: in adults eg, nicotine (irritant) or rubber ( allergy).Behcet disease: oral and genital aphthous ulcers, ocular inflammation, skin lesions, pathergy and other symptoms and signs due to multisystem vasculitis (adults).Complex aphthosis: almost constant ulcers, oral and genital aphthous ulcers (adolescents, adults).Aphthous ulceration: up to 20% children > older age more common in Caucasians than other races, more common in females than in males.Acute febrile neutrophilic dermatosis (Sweet syndrome) - with papulovesicular plaques, fever, neutrophilia.Drug-induced stomatitis - eg, chemotherapy, low-dose methotrexate ( irritant), non-steroidal anti-inflammatory drugs ( NSAIDs) ( lichenoid pattern).Acute necrotising ulcerative gingivitis.Stevens-Johnson / toxic epidermal necrolysis (any age).Various consequences of human immunodeficiency virus infection.Varicella-zoster virus: chickenpox (children) or sometimes, shingles (any age, especially elderly).Epstein–Barr virus and cytomegalovirus (adolescents).Enterovirus 71 infection: hand, foot and mouth disease (children or adults of any age).Herpes simplex: primary (in children) or recurrent cold sores (any age).Candida albicans infection: oral thrush in babies, elderly and debilitated.Males and females of all ages and races experience mouth ulcers. Who gets mouth ulcer and how are mouth ulcers classified?