“What are Key Differences Between Aphthous Ulcers, Herpetic Stomatitis, and Erythema Multiforme?”

7.14.24 Quick Review #178 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental Aphthous Ulcers (Canker Sores) Key Characteristics: • Common, non-contagious, and recurrent • Exact cause often unknown, but may be related to immune response, stress, nutritional deficiencies, or trauma Clinical Features: • Occur on non-keratinized mucosa (e.g., inside cheeks, lips, under the tongue) • Small, round or oval ulcers with a yellowish or white center and a red halo Signs and Symptoms: • Painful lesions, especially when eating or speaking • No systemic symptoms Histology: • Superficial ulceration with a fibrinopurulent membrane • Inflammatory infiltrate mainly composed of lymphocytes, macrophages, and occasional neutrophils Herpetic Stomatitis Key Characteristics: • Caused by Herpes Simplex Virus (HSV), usually HSV-1 • Contagious and often recurrent Clinical Features: • Typically affects keratinized mucosa (e.g., gingiva, hard palate) • Multiple vesicles that rupture to form shallow, painful ulcers Signs and Symptoms: • Acute cases often present with fever, malaise, and lymphadenopathy • Vesicles can coalesce into larger ulcerations Histology: • Intraepithelial vesicles and ballooning degeneration of epithelial cells • Multinucleated giant cells and eosinophilic intranuclear inclusions (Cowdry type A bodies) • Acantholysis and necrosis of epithelial cells Erythema Multiforme (EM) Key Characteristics: • Hypersensitivity reaction often triggered by infections (e.g., HSV, Mycoplasma pneumoniae) or medications • Acute and sometimes recurrent Clinical Features: • Target or iris-like skin lesions • Oral lesions can appear on both keratinized and non-keratinized mucosa • Large, irregular, and painful ulcers Signs and Symptoms: • Systemic symptoms like fever, malaise, and arthralgia may be present • Severe cases can involve ocular and genital lesions (Stevens-Johnson syndrome) Histology: • Subepithelial and intraepithelial vesiculation • Necrosis of basal keratinocytes • Mixed inflammatory infiltrate with lymphocytes, neutrophils, and eosinophils References: 1. Petruzzi, M., Galleggiante, S., & della Vella, F. (2022). Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: A report of four cases. BMC Oral Health, 22(1), Article 90. 2. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2016). Oral and Maxillofacial Pathology (4th ed.). Elsevier. 3. Regezi, J. A., Sciubba, J. J., & Jordan, R. C. (2017). Oral Pathology: Clinical Pathologic Correlations (7th ed.). Elsevier. 4. Scully, C., & Porter, S. (2008). Oral mucosal disease: Recurrent aphthous stomatitis. British Journal of Oral and Maxillofacial Surgery, 46(3), 198-206. 5. ChatGPT. 2024. - #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher