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Head and Neck Pathology Mar 2019Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient... (Review)
Review
Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.
Topics: Humans; Mouth Mucosa; Oral Ulcer
PubMed: 30701449
DOI: 10.1007/s12105-018-0981-8 -
International Journal of Dermatology Nov 2022Eosinophilic ulcer of the oral mucosa is a benign, reactive, self-limited lesion. Its pathogenesis is unclear, and it clinically manifests as a punched-out ulcer with... (Review)
Review
Eosinophilic ulcer of the oral mucosa is a benign, reactive, self-limited lesion. Its pathogenesis is unclear, and it clinically manifests as a punched-out ulcer with surrounding indurated border, raising suspicion for a possible malignancy. On histology, an acute and chronic dense inflammatory infiltrate can be appreciated, which can extend to the deep underlying tissue (including skeletal muscle). Eosinophils are especially conspicuous on hematoxylin and eosin staining and might play an important role in the development of the ulcer. Removal of possible triggers followed by monitoring and possible biopsy are among the initial recommendations. Most lesions heal spontaneously without the need for intervention. This review aims at assisting dermatologists to easily recognize this entity, avoiding unnecessary interventions and apprehension.
Topics: Eosine Yellowish-(YS); Eosinophilia; Hematoxylin; Humans; Mouth Mucosa; Oral Ulcer; Ulcer
PubMed: 34812492
DOI: 10.1111/ijd.15986 -
CA: a Cancer Journal For Clinicians Jan 2022Oral mucositis (OM) is a common, highly symptomatic complication of cancer therapy that affects patients' function, quality of life, and ability to tolerate treatment.... (Review)
Review
Oral mucositis (OM) is a common, highly symptomatic complication of cancer therapy that affects patients' function, quality of life, and ability to tolerate treatment. In certain patients with cancer, OM is associated with increased mortality. Research on the management of OM is ongoing. Oral mucosal toxicities are also reported in targeted and immune checkpoint inhibitor therapies. The objective of this article is to present current knowledge about the epidemiology, pathogenesis, assessment, risk prediction, and current and developing intervention strategies for OM and other ulcerative mucosal toxicities caused by both conventional and evolving forms of cancer therapy.
Topics: Antineoplastic Agents; Hematopoietic Stem Cell Transplantation; Humans; Mouth Mucosa; Neoplasms; Oral Ulcer; Prevalence; Quality of Life; Radiation Injuries; Severity of Illness Index; Stomatitis
PubMed: 34714553
DOI: 10.3322/caac.21704 -
Medicina Clinica Dec 2015
Review
Topics: Administration, Oral; Administration, Topical; Anti-Inflammatory Agents; Diagnosis, Differential; Humans; Neoplasms; Oral Ulcer; Recurrence; Syphilis; Tuberculosis; Virus Diseases
PubMed: 26049962
DOI: 10.1016/j.medcli.2015.04.017 -
Italian Journal of Dermatology and... Dec 2021
Topics: Eosinophilic Granuloma; Humans; Mouth Mucosa; Oral Ulcer; Ulcer
PubMed: 30717576
DOI: 10.23736/S2784-8671.19.06296-5 -
Ear, Nose, & Throat Journal Nov 2011
Topics: Diagnosis, Differential; Humans; Male; Mouth Mucosa; Oral Ulcer; Stomatitis, Aphthous
PubMed: 22109918
DOI: No ID Found -
Journal of Dental Research Feb 2022Oral ulcer is a common oral inflammatory lesion accompanied by severe pain but with few effective treatments. Cannabidiol (CBD) is recently emerging for its therapeutic...
Oral ulcer is a common oral inflammatory lesion accompanied by severe pain but with few effective treatments. Cannabidiol (CBD) is recently emerging for its therapeutic potential in a range of diseases, including inflammatory conditions and cancers. Here we show that CBD oral spray on acid- or trauma-induced oral ulcers on mice tongue inhibits inflammation, relieves pain, and accelerates lesion closure. Notably, the enrichment of genes associated with the NOD, LRR, and NLRP3 pyrin domain-containing protein 3 (NLRP3) inflammasome pathway is downregulated after CBD treatment. The expression of cleaved-gasdermin D (GSDMD) and the percentage of pyroptotic cells are reduced as well. In addition, CBD decreases the expression of cytidine/uridine monophosphate kinase 2 (CMPK2), which subsequently inhibits the generation of oxidized mitochondria DNA and suppresses inflammasome activation. These immunomodulating effects of CBD are mostly blocked by peroxisome proliferator activated receptor γ (PPARγ) antagonist and partially antagonized by CB receptor antagonist. Our results demonstrate that CBD accelerates oral ulcer healing by inhibiting CMPK2-mediated NLRP3 inflammasome activation and pyroptosis, which are mediated mostly by PPARγ in the nucleus and partially by CB in the plasma membrane.
Topics: Animals; Cannabidiol; Inflammasomes; Mice; Mice, Inbred NOD; NLR Family, Pyrin Domain-Containing 3 Protein; Oral Ulcer
PubMed: 34269108
DOI: 10.1177/00220345211024528 -
Oral Diseases Jun 2019To detail a scoping review on the global and regional relative frequencies of oral mucosal disorders in the children based on both clinical studies and those reported... (Review)
Review
OBJECTIVE
To detail a scoping review on the global and regional relative frequencies of oral mucosal disorders in the children based on both clinical studies and those reported from biopsy records.
MATERIALS AND METHODS
A literature search was completed from 1 January 1990 to 31 December 2018 using PubMed and EMBASE.
RESULTS
Twenty clinical studies (sample size: 85,976) and 34 studies from biopsy services (40,522 biopsies) were included. Clinically, the most frequent conditions were aphthous ulcerations (1.82%), trauma-associated lesions (1.33%) and herpes simplex virus (HSV)-associated lesions (1.33%). Overall, the most commonly biopsied lesions were mucoceles (17.12%), fibrous lesions (9.06%) and pyogenic granuloma (4.87%). By WHO geographic region, the pooled relative frequencies of the most common oral lesions were similar between regions in both clinical and biopsy studies. Across regions, geographic tongue (migratory glossitis), HSV lesions, fissured tongue and trauma-associated ulcers were the most commonly reported paediatric oral mucosal lesions in clinical studies, while mucoceles, fibrous lesions and pyogenic granuloma were the most commonly biopsied lesions.
CONCLUSIONS
The scoping review suggests data from the clinical studies and biopsy records shared similarities in the most commonly observed mucosal lesions in children across regions. In addition, the majority of lesions were benign in nature.
Topics: Biopsy; Child; Congresses as Topic; Humans; Mouth Diseases; Mouth Mucosa; Oral Medicine; Oral Ulcer; Stomatitis, Aphthous
PubMed: 31034120
DOI: 10.1111/odi.13112 -
Archives of Oral Biology Dec 2022The aim of this study is to investigate effects of cisplatin preadministration on oral ulcerative mucositis-induced nociception by using an experimental model of rats.
OBJECTIVE
The aim of this study is to investigate effects of cisplatin preadministration on oral ulcerative mucositis-induced nociception by using an experimental model of rats.
DESIGN
After two rounds of cisplatin administration, oral ulcers developed with topical acetic acid treatment in rats. Spontaneous mouth rubbing behavior was observed as spontaneous nociceptive behavior in a plastic cage. Head-withdrawal behavior was observed as mechanical allodynia by using von Frey test in the oral mucosa of conscious rats. Bacterial invasion and inflammatory cell infiltration into oral ulcerative region and systemic leukocyte phagocytic activity were assessed.
RESULTS
Following cisplatin preadministration, oral ulcerative mucositis-induced spontaneous nociceptive behavior was not observed in the model. The preadministration enhanced leukocyte phagocytic activity, leading to reduce bacterial invasion and inflammatory cell infiltration in the oral ulcerative region. In contrast, oral ulcerative mucositis-induced mechanical allodynia was induced. The exaggerated mechanical allodynia in the oral ulcerative region was largely inhibited by topical treatment with the antioxidative drug, ɑ-lipoic acid, or the blocker of N-formyl peptide receptor 1, N-t-butoxycarbonyl-methionyl-leucyl-phenylalanine.
CONCLUSIONS
These results suggest that cisplatin preadministration suppresses spontaneous nociception in oral ulcerative region, due to antiinflammatory effects by enhancement of leukocyte phagocytic activity, but exaggerates mechanical allodynia due to oxidative stress with N-formyl peptide receptor 1 activation. The suppression of spontaneous nociception is one of the advantages of cisplatin treatment for head and neck cancer patients although the exaggerated allodynia is a serious symptom.
Topics: Rats; Animals; Cisplatin; Nociception; Hyperalgesia; Oral Ulcer; Receptors, Formyl Peptide; Mucositis; Stomatitis
PubMed: 36265393
DOI: 10.1016/j.archoralbio.2022.105572 -
Pediatric Dermatology Jul 2022
Topics: Humans; Oral Ulcer
PubMed: 36000940
DOI: 10.1111/pde.14974