Mount Sinai Journal of Medicine - Volume 65, Number 5&6, Page 383

Volume 65 Number 5&6
October/November 1998 back to contents

Diagnosis of Oral Ulcers 383

Lawrence C. Schneider, B.D.S., Ph.D.¹, And Adina E. Schneider, M.D.²

From the ¹Department of Oral Pathology, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, NJ, and ²Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. ¹Professor and ²Clinical Instructor.

Address correspondence to Lawrence C. Schneider, B.D.S., Ph.D., University of Medicine and Dentistry of New Jersey, New Jersey Dental School, Department of Oral Pathology, 110 Bergen Street, Newark, NJ 07103.

ABSTRACT
Ulcers commonly occur in the mouth. Their causes range from minor irritation to malignancies and systemic diseases. Innocent solitary ulcerations, which result from trauma and infections, must be distinguished from squamous cell carcinomas, which also typically present as solitary ulcers. Multiple oral ulcers may be classified as acute, recurrent and/or chronic. The most common causes of rapid-onset oral ulcers include acute necrotizing ulcerative gingivitis, allergies and erythema multiforme. The two common forms of acute (short-term) recurrent oral ulcers, "cold sores" or "fever blisters," which are caused by the herpes simplex virus, and recurrent aphthous ulcers ("canker sores"), may be distinguished largely on the basis of their location. Most types of multiple chronic oral ulcers are associated with disturbances of the immune system. They include erosive lichen planus, mucous membrane pemphigoid and pemphigus vulgaris. Clinical criteria which are most useful in identifying the cause of oral ulcers are vesicles or bullae, which may not be seen because they rupture rapidly in the oral environment; constitutional signs and symptoms; and lesions on the skin and/or other mucosa. In some cases, diagnosis depends upon culture or biopsy, particularly with the application of immunofluorescence to the surgical specimen.

KEY WORDS
Oral ulcers, vesiculobullous oral lesions, gingival ulcers, mucosal ulcerations

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Volume 65 Number 5&6 October/November 1998	back to contents

Diagnosis of Oral Ulcers	383
Lawrence C. Schneider, B.D.S., Ph.D.¹, And Adina E. Schneider, M.D.²
From the ¹Department of Oral Pathology, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, NJ, and ²Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. ¹Professor and ²Clinical Instructor. Address correspondence to Lawrence C. Schneider, B.D.S., Ph.D., University of Medicine and Dentistry of New Jersey, New Jersey Dental School, Department of Oral Pathology, 110 Bergen Street, Newark, NJ 07103.