TAILIEUCHUNG - Ebook Cawson’s essentials of oral pathology and oral medicine (8/E): Part 2

(BQ) Part 2 book “Cawson’s essentials of oral pathology and oral medicine” has contents: Tongue disorders, benign chronic white mucosal lesions, oral premalignancy, common benign mucosal swellings, immunodefi ciencies and HIV disease, and other contents. | SECTION 2 SOFT TISSUE DISEASE 205 CHAPTER 12 Diseases of the oral mucosa: introduction and mucosal infections A few mucosal diseases, such as lupus erythematosus, are important indicators of severe underlying systemic disease and rare conditions, such as acanthosis nigricans, can be markers of internal malignancy. Pemphigus vulgaris is potentially lethal, as is HIV infection – which can give rise to a variety of mucosal lesions. Biopsy is mandatory, particularly in the bullous diseases as, in such cases, the diagnosis can only be confirmed by microscopy. In other cases, microscopic findings can be less definite, but often (as in the case of major aphthae for example) serve to exclude more dangerous diseases. Mucosal ulceration – a break in epithelial continuity – is a frequent feature of stomatitis. Important causes are summarised in Table . However, ulceration is not a feature of all mucosal diseases as discussed below. PRIMARY HERPETIC STOMATITIS ➔ Summary p. 221 Primary infection is caused by Herpes simplex virus, usually type 1, which, in the non-immune, can cause an acute vesiculating stomatitis. However, most primary infections are subclinical. Thereafter, recurrent (reactivation) infections usually take the form of herpes labialis (cold sores or fever blisters). Transmission of herpes is by close contact and up to 90% of inhabitants of large, poor, urban communities, develop antibodies to herpes virus during early childhood. In many British and US cities, by contrast, approximately 70% of 20-yearolds may be non-immune, because of lack of exposure to the virus. In such countries, the incidence of herpetic stomatitis has declined and it is seen in adolescents or adults, rather than children. It is more common in the immunocompromised, such as HIV infection, when it can be persistent or recurrent. Clinical features The early lesions are vesicles which can affect any part of the oral mucosa, but the hard palate and dorsum of the tongue are favoured .

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