Acute Chronic Recurrent

solitary multiple solitary multiple Solitary/multiple

Varicella-Zoster

Behçet's
ulcerative gingivitis

Oral
gingivostomatitis

Erythema

squamous cell
related

carcinoma
Ulcerative

Mucous membrane
hypersensitivity
Necrotizing

Primary herpetic

Necrotizing

)Lichen planus (LP

Chemotherapy-

LE
Coxsackievirus
sialometaplasia

pemphigoid

herpes stomatitis
Pemphigus vulgaris

Bullous pemphigoid

aphthous stomatitis
multiforme
Traumatic

Necrotizing sialo-
sialometaplasia
Shingles
Chickenpox

Tuberculous
Deep fungal
Syphilitic
def -Herpes -Varicella -herpes acute endogenou Auto- autoimmun chronic Recurring
Simplex Generalized zoster inflamm- s oral immune e sub- immune oral
-gingivitis and - Primary ][HZ atory skin infection + D + intra epidermal -ologic mucosa
.stomatitis infection - and necrosis of epithelia blistering + inflam- ulcers +
inflammation Reactivati mucous the gingiva l less matory no other
of the oral on of blisterin dangerous mucocu- signs
mucosa and latent g+ than taneous
.gingiva virus in erosion pemphigus
cause -initial First time the Immune -dental Chemother Drugs Heredity,
infection an dorsal mediated material apy → medica- hematolo
.)Type 1( individual root initiated s cytotoxic tions gic ,
-Contact to contact ganglia of by -oral effects of immunol

s
.carrier spinal Herpes hygiene the drugs Reiter's syndrome: ogic ,
Recent trauma

Autoimmune
nerves or antigens+ products Arthritis, urethritis, conjunctivitis and trauma,

er
extra Drugs: -Foods mucocutaneous(skin) lesions. stress,
Oral ulcer 20-40% in buccal mucosa,
medullar oxycam & - .foods

lc
gingiva, and lips.
y ganglia (NSAIDs) unknow M>F
of cranial sulfonami n

U
with Family history
nerves des etiology
results in

l
localized

ra
.lesions
age 1-10 y not 5 - 10y Over50 young 18-20y 20-40y 40-60y Over50 over 40 20- 2nd
history

sex M
before 6mon
as maternal IG O M M F F
y / most
55
F
40y decade

F F
pain NOT except NOT except
ulcerative lesions in oral cavity are painful → due to trauma secondary and secondarily (late stage) bacterial infections
secondary
Prodromal Fever, fever, burning Fever, Burning Burning
period headache, malaise, pain 2 to chills, sensation /tingling
malaise, pruritic, 4 days anorexia 48 hours /itching
nausea, .rash +vesicles sore before sensatio
vomiting throat, ulcer n
1-2 day dysphagia
.2-10 day
medical ..anemia & leukemia→Neutropenic ulcer / GIT→bowel disease / Neoplasms→ Metastatic lesions / DM
family have have genetic
genetic predisposition
predisp
osition
other Excess Dysphagia Tissue Bleeding remission & Similar lesions

eye lesions
salivation and fixation exacerbation

Genital &
inability to eat & skin lesions
 Acute Chronic Recurrent

solitary multiple solitary multiple Solitary/multiple

Varicella-Zoster Pemphigus vulgaris

Behçet's
ulcerative gingivitis

Ulcerative squamous

Deep fungal
gingivostomatitis

related

cell carcinoma

Mucous membrane
Oral hypersensitivity

Syphilitic
Necrotizing

Primary herpetic

Necrotizing

Necrotizing

)Lichen planus (LP

Chemotherapy-

LE
Coxsackievirus

Tuberculous
sialometaplasia

sialometaplasia

pemphigoid

herpes stomatitis
Bullous pemphigoid

aphthous stomatitis
Erythema multiforme
Traumatic

Shingles
Chickenpox
skin tiny vesicles on the Mixed stages (papules, C) Hand-foot- Target, iris, - Desquamative

Localized in skin &

C.P & Examination

vesicles and ulcers at the

mucous
.Butterfly skin on face + Alopecia
perioral skin )vesicles, pustules, crust and-mouth Bull's eye gingivitis( DG):

burning sensation or
vermillion border Disease lesion gingival

soreness erythema,
successive Unilateral

Bilateral DG
‫المعلومة‬ waves for lesions on (concentric erythematous,

.site of contact
‫دى‬

Skin > mucosa

3-6 days head and erythemato erosion, blister.
‫لالختصار‬ (due to neck at .)us rings - soft blister + clear
‫بس‬ repeated the area fluid appears on
DM waves of supplied healthy or irritated

. Recurring oral, genital, Eye lesions

:punche skin or mucosa
)viremia by 5th CN
d out commonly :oral
Lymph node Regional Other are : hard fixed (malignant) / soft mobile (inflammatory)
edge

Pharyngitis : Yellow-white nodules

blisters (buccal and

.don't progress to vesicle or ulcers

lymphadenopathy

s
.Vesicles in the posterior palate
palatine ), Other

A) Herpangina :From ruptured

ulcer erythematous, and Generalize Large, Oral mucosa > D -NON Keratinized

er
Raised rolled out edge
swollen gingiva → d pruritic irregular, mucosal surfaces in conjunctiva > G mucosa

Undermined edge &

B) Acute Lymphonodular

b. erythematus & ulcerative

Healed

Keratinized mucosa
(generalized acute macuolopa deep, body may also be skin > other
ulcer affected body mucous

lc
Surrounding )marginal gingivitis pular eroded, : Minor : Major

caseating floor
:sloppin - Ulcers Floor + DG soft - -
tissue both Keratinized - bleed mobile indurate
g edge

U
& Non k- mucosa crusting lip :Grayish yellowish base d base
exudate fibrinous - gray -
exudate sloughed
- NO inflammatory floor floor

l
.hallow

ra
types A/ B/ C Minor / major / Labiali

a. keratotic
s RHL
herptiform

Multinucleated giant cells-

O Tranck cells (acantholytic
(multiple)
Intaora
l RIH
l
investigation

cytologica

:epithelial cells nucleus- cells) have round, swollen,

Lipschutz bodies hyperchromic nuclel
.Ballooning degeneration surrounded by narrow

hyper parakeratosis/ thickening granular cell layer / A saw-

.cytoplasm

nd: is within the nuclel of the epidermal cells 2

st: is a bandlike deposit along the basement 1
-Liquefaction degeneration, or necrosis of the basal cell
Subra basilar clefts Separation

An eosinophilic band may be seen just beneath the -

histopatho

.)membrane ("lupus band test" is positive

/Intra epithelial basement
.vesicle membrane zone /
Sub epithellal

(antinuclear antibodies are present

vesicle

.toothed appearance to the rete pegs

Direct: detect Bounded antibodies from the patient tissue IG attach keratinocytes IG attached at the base-
Fluorescence dyes attach to antibodies & Detect by
fluorescent

.surface antigens .ment membrane zone

Immuno-

microscope Indirect: detect Circulating autoantibodies from patient serum over a IG attach intercellular IG attach desmosomes
(IF)

desmosomes in basement membrane +ve

slide from monkey esophagus Pathergy
test
ve patch test +
patch

:Inflamma

basement membrane
:eryth-ema tion &
&edema small
&vesicle in sterile
insertion site pustule at
insertion
for 48h site
Nikolsky +ve / Vesicle on
specific

normal mucosa or skin due

.layer
to epithelial split + subra-
basilar cleft
TTT Self limiting then become latent 17+4+3+2 ‫عشان بس تفهم المصطلحات بص على الصفحات دى من ورق التيم‬
in ganglion then Reactivation