Oral Manifestations of Systemic Diseases Reference: Pinkham, Chapter 4

HERPETIC GINGIVOSTOMATITIS Causative Agent: Herpes Simplex Virus (HSV) Type I Evaluation: Viral infection S/S (malaise, fever..etc) Clinical: - Vesicle develop on the lips, tongue, gingival, palate Vesicles rupture to form large painful ulcers - Gingiva: Edematous, bleeds easily

HERPETIC GINGIVOSTOMATITIS Diagnosis: Age: Young patients History : First exposure to HSV Viral culture, serum antibody Treatment: SELF-LIMITING (7-10 DAYS) Palliative: Bed rest, fluids…etc.

RECURRENT HERPES SIMPLEX (HERPES LABIALIS) Causative Agent: HSV – I (reactivation of the virus lying in the trigeminal ganglion. Clinical Presentation: - Hx of similar lesion - Small ulcers in the lip at: - mucocutaneous junction or - at the corner of the mouth, or - beneath the nose

RECURRENT HERPES SIMPLEX (HERPES LABIALIS) Diagnosis: Subjective findings: - Itching before ulcer development. - Mild flu like symptoms. Objective findings: - Vesicles (2-4 mm), rupture and crust over 36-48 hrs. - Healing in 7-10 days. Treatment: Self-limiting. Healing without scar.

HERPES ZOSTER (CHICKEN POX) Causative Agent: Varicilla-Zoster Virus (reactivation) Evaluation: Exposure to infected person More common in winter and spring time Most patients develop life-immunity

HERPES ZOSTER (CHICKEN POX) Diagnosis: Subjective: Fever, malaise, chills Objective: Vesicles starts on trunk, spread to extremities. Lesions crust and heal. Oral: Vesicles that rupture leaving small ulcers with red margins. Treatment: - Self-limiting - Contagious - Palliative treatment - Nails

HERPENGINA Causative Agent: Coxsakie A Virus (types 2,3,4,5,6,8,10). Evaluation: Common in young children (< 4 yrs) Recent exposure to infected person (epidemic) More common during summer and fall.

HERPENGINA Diagnosis: Treatment: Subjective: Viral infection S/S (fever, malaise ..etc) Objective: Multiple vesicles on soft palate and tonsillar area. Vesicles ulcerate (gray with erythematous base). Ulcers are painful. Treatment: - Self-limiting - Contagious - Palliative treatment - Fluid (dehydration)

HAND, FOOT, AND MOUTH DISEASE Causative Agent Coxsakie A Virus (A-16) Evaluation: Epidemics, more common in children

HAND, FOOT, AND MOUTH DISEASE Diagnosis: Subjective: Incubation (2-6 days) followed by viral S/S. Objective: Painful vesicles that ulcerate. Oral: Hard palate, tongue and buccal mucosa Palms and soles Treatment: Self-limiting (7-10 days), healing without scaring Palliative treatment

IMPETIGO Causative Agent: Evaluation: Two Types: Bullous caused by staphylococci Non-bullous caused by streptococci Evaluation: Gram stain good for bullous type Throat cluture

IMPETIGO Diagnosis: Subjective: Hx of insect bites, exposure to infected person. Lesions are asymptomatic Objective: Non-Bullous: Lesion: Thick, adherent-yellowish-brown crust (coalesce to form large lesion). Found in face and extremities. Bullous: Flaccid large bullae (anywhere) 2-3 days rupture discrete round lesion plycyclic area Treatment:

SCARLET FEVER Causative Agent Clinical Presentation

SCARLET FEVER Diagnosis: Treatment:

CANDIDIASIS Causative Agent Clinical Presentation

CANDIDIASIS Diagnosis: Treatment:

DIABETES MELLITS Causative Agent Clinical Presentation

DIABETES MELLITS Diagnosis: Treatment:

ACUTE LYMPHOBLASTIC LEUKEMIA Causative Agent Clinical Presentation

ACUTE LYMPHOBLASTIC LEUKEMIA Diagnosis: Treatment:

SICKLE CELL ANEMIA Causative Agent Clinical Presentation

SICKLE CELL ANEMIA Diagnosis: Treatment:

HISTIOCYTOSES (HISTOCYTOSIS X) Causative Agent Clinical Presentation

HISTIOCYTOSES (HISTOCYTOSIS X) Diagnosis: Treatment:

HEMOPHILIA (HEMOPHILIA A; FACTOR VIII DEFICINENCY) Causative Agent Clinical Presentation

HEMOPHILIA (HEMOPHILIA A; FACTOR VIII DEFICINENCY) Diagnosis: Treatment:

PEDIATRIC HUMAN IMMUNO-DEFICNEINCY VIRUS INFECTION Causative Agent Clinical Presentation

PEDIATRIC HUMAN IMMUNO-DEFICNEINCY VIRUS INFECTION Diagnosis: Treatment:

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