Tuesday, September 9, 2014

Dermatologic disorders/diseases of the #mouth and #lips. Font: Globale Dermatologie.

Fordyce Glands
These are very common skin lesions found in normal individuals. White spots are seen on the inner walls of the buccal cheeks and along the lips. They are aberrant oil glands (sebaceous) and are harmless. There is no specific treatment.

Fissured Tongue
A fissured tongue has prominent furrows on its surface. It can be seen in normal people but is more common in individuals with Down’s Syndrome. There is no specific treatment for this disorder and is best left alone.

Oral Candidiasis
It is an infection caused by Candida yeast. It is sometimes seen in children and also in adults with poor fitting dentures, taking broad-spectrum antibiotics or oral steroid or suffering from diabetes or other immunologic deficiencies. 
White, creamy patches appear in the oral mucosa or tongue; raw red spots are seen when the white patches are scraped off.
Treatment include a correct oral hygiene, elimination of the predisposing factors and the use of topical or/and oral antifungal agents. Patients should consult their doctors to be investigated. They should not self-medicate as an underlying disorder has to be excluded.
    Oral Candidiasis
      Oral Candidiasis

      Oral Leukoplakia
      Commonly seen in the elderly, it appears as white patches on the surface of the tongue or buccal mucosa. The white patches cannot be easily wiped off. Smoking, tobacco chewing and chronic irritation (eg. from poorly fitting dentures) predispose to leukoplakia. The lesion may become cancerous. Thus, biopsy and close follow-up are required.

      Actinic Cheilitis
      It is caused by chronic sun exposure on the lips. The lesion can transform into skin cancer and needs to be removed.

        Actinic Cheilitis

        Herpetic Gingivostomatitis
        Herpes de la lèvre (bouton de fièvre)
        Herpetic gingivostomatitisHerpetic gingivostomatitis
        The infection is caused by Herpes Simplex virus and often occurs in children.Blisters, erosions and crusting may be seen on the lips and buccal mucosa. Commonly, the child also has fever, malaise and enlarged lymph nodes. Generally, it is a recurrent infectious disease.
        Severe attacks may require an oral antiviral agent. It usually takes 2 weeks for the complete healing. 

        Apthous Ulcers
        It is a troublesome condition that affects normal individuals. It presents with recurrent episodes of small painful ulcers on the tongue and/or buccal mucosa, each episode lasting one to several weeks before healing. For some patients, it may be a manifestation of iron, folate or vitamin B12 deficiency. 
        Symptomatic treatment may be given with anti-inflammatory analgesic/ anaesthetic gels. They can be treated with topical steroid gel. More severe cases may require oral medication.

        Oral Lichen Planus
        Oral lichen planus appears as white streaks in a lace-like pattern on the tongue and/or buccal mucosa. It is usually associated with purplish skin lesions on the body especially around the wrists and ankles. The oral lesions may be itchy, painful or asymptomatic. A biopsy is usually taken to confirm the diagnosis and to exclude malignant transformation. Oral lichen planus is treated with a topical steroid gel.

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