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Lesions in Mouth
Mouth lesions can be seen in different diseases and conditions. They may be associated with disease or sometimes hereditary or even normal. Some lesions even indicate the pre-cancerous condition. Oral lesions can be broadly classified into four different types.
VESICULO–BULLOUS LESIONS :- These lesions are in the form of superficial blisters of diameter <5mm (vesicle) and >5mm (bulla) usually filled with a clear fluid.
1.Hereditary –Epidermolysis bullous dystrophica
2.Viral – Smallpox, Measles, Chicken pox, Herpes simplex, Herpes zoster, Herpangina, Hand Foot Mouth disease
3.Muco cutaneous – Erythema multiforme, Bechet's syndrome , Reiter syndrome, Steven Johnson syndrome
4.Immunological – Pemphigus ( vulgaris, vegetans, foliaceous , erythematous),Benign mucous membrane pemphigoid
5.Psychosomatic – Bullous lichen planus
6.Allergic –Stomatitis medicamatosa, Stomatitis venennata
7.Toxicity – Toxic lesions
8.Miscellaneous – Submucous fibrosis, Apthous stomatitis, Thermal and Chemical burns.
ULCERATIVE LESIONS :- These lesions are characterized by loss of surface epithelium and frequently some underlying connective tissue.They often appear elevated or depressed.
1.Injury - physical, chemical, thermal,radiation, actinic rays
a) Bacterial :– Vincent's angina
b) Viral :–Herpes simplex ,Herpes zoster, Herpangina
c) Fungal :– Candidiasis
3.Nutritional deficiencies - protein , B complex
4.Allergic - Stomatitis venenata, S.medicamatosa, Fixed drug allergy, Anesthetic reaction during dental extraction.
5.Mucocutaneous - Erythema multiforme, Steven-Johnson syndrome, Reiter syndrome, Bechet's disease, Epidermolysis bullosa, Erosive lichen planus
6.Immunological - Pemphigus vulgaris, P.vegetans, P.foliaceous
7.Idiopathic - major apthous ulcer, minor apthous ulcer, herpetform ulcer
8.Systemic -Pyostomatitis vegetans, Uremic stomatitis, Rhinosporidium, Haematological disease
9.Neoplastic -Malignant ulcers
10.Miscellaneous - Foliate papillitis, Necrotizing sialometaplasia.
WHITE LESIONS :- White lesions are described as abnormal areas of the mucosa that appear whiter than the surrounding tissue and are usually raised, roughened or of different texture from adjacent tissue.
1.Normal variants - Leukoedema , Fordyces granules, Linea alba
2.Heriditary - Leukoedema, White spongy nevus, HBID, Dyskeratosis congenita
a) Precancerous Lesions :– Leukoplakia, Erythroplakia, Bowen's disease, Actinic keratosis, Actinic chelitis
b) Precancerous Condition :– Oral sub mucous fibrosis, Syphilis, Oral lichen planus, Dyskeratosis congenita, Lupus erythematous, Psoriasisis
4.Skin diseases - White spongy nevus, HBID, Parakeratosis, Keratosis follicidans, Warty dyskeratosis, Psuedoxanthoma elasticum
5.Systemic diseases - Uremic stomatitis, Diabetes stomatitis, Ulcerative stomatitis
6.Infections:- Oral hairy luekoplakia, Candidiasis, Parulis, Mucous patches
7.Traumatic:- Cheek biting, Frictional keratosis, Aspirin burn
RED LESIONS :- Red lesion is an area of reddened mucosa that may be smooth and atrophic looking or exhibits a granular,velvety texture.
1.Traumatic - Mechanical, Chemical and Thermal injuries
a) Bacterial :- Scarlet fever, Gingivostomatitis
b) Fungal :- Erythematous candidiasis
C) Viral : - Measles, Lymphonodular pharyngitis
3.Vascular - Haemangioma, Agranulocytosis
4.Dermatological - Pemphigus, Erythema multiforme, Erosive lichen planus, Lupus erythematosus
5.Systemic diseases - Uremic stomatitis, Ulcerative stomatitis, Diabetes, Scurvy, Pernicious anemia
6.Premalignant and malignant condition - Speckled leukoplakia, Erythroplakia, Systemic lupus erythematosus, Kaposi's sarcoma, Carcinoma in situ