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Microsoft word - common superficial oral lesions table 1.docx

Common Superficial Oral Lesions TABLE 1
From: Common Oral Lesions: Part I. Superficial Mucosal Lesions.
Am Fam Physician. 2007 Feb 15;75(4):501-506.WANDA C. GONSALVES, M.D., ANGELA C.
CHI, D.M.D., and BRAD W. NEVILLE, D.D.S., Medical University of South Carolina, Charleston, South
Carolina
Condition
Clinical presentation
Treatment
Comments
Candidiasis4– Pseudomembranous:
Topical antifungals (e.g.,
Can confirm
adherent white plaques that nystatin [Mycostatin]
diagnosis with oral
may be wiped off
suspension or troches,
exfoliative cytology
“Thrush”
Erythematous: red macular clotrimazole [Mycelex]
(stained with
lesions, often with a burning troches, fluconazole
periodic acid-
sensation
[Diflucan] suspension, or
Schiff or potassium
Perlèche (angular cheilitis): systemic antifungals (e.g.,
hydroxide), biopsy,
erythematous, scaling
fluconazole, ketoconazole
or culture
fissures at the corners of the [Nizoral], itraconazole
mouth

[Sporanox])
Recurrent
Prodrome (itching, burning, Immunocompetent patients Reactivation
tingling) lasts approximately usually do not require
triggers:
labialis10–14 12 to 36 hours, followed by
treatment
ultraviolet light,
eruption of clustered vesicles Topical agents include 1%
trauma, fatigue,
along the vermilion border penciclovir cream (Denavir) stress,
that subsequently rupture,

Systemic agents (e.g.,
menstruation
ulcerate, and crust
acyclovir [Zovirax],
valacyclovir [Valtrex],
famciclovir [Famvir]) are
most effective if initiated
during prodrome or as
prophylaxis

Recurrent
Ulcers surfaced by a
Mild cases do not require
aphthous
yellowish-white
treatment
stomatitis15– pseudomembrane
Fluocinonide gel (Lidex) or
surrounded by erythematous triamcinolone acetonide
halo

(Kenalog in Orabase),
amlexanox paste
(Aphthasol), chlorhexidine
gluconate (Peridex)
mouthwash

Erythema
Migrating lesions with
Asymptomatic cases do not
migrans18 or central erythema surrounded require treatment
Geographic by white-to-yellow elevated Symptomatic cases may be
tongue” borders; typically on tongue treated with topical
or

corticosteroids, zinc
“Glossitis
supplements, or topical
migrans”
anesthetic rinses
Condition
Clinical presentation
Treatment
Comments
Elongated filiform papillae Regular tongue brushing or Predisposing
tongue19–21
scraping; avoidance of
factors include
predisposing factors
smoking and poor
oral hygiene as
well as antibiotics
and psychotropics

Reticular: white, lacy striae Asymptomatic cases do not Buccal lesions
planus22
require treatment
typical in reticular
Erosive: erythema and ulcers Symptomatic cases may be
form; other sites
with peripheral radiating
treated with a topical
(e.g., tongue,
striae, erythematous and
corticosteroid gel or mouth gingiva) may be
ulcerated gingiva
involved
Information from references 4 through 22.

Source: http://dentalboard.org/pdf/adhp/LesionsTable.pdf

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