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Supporative
Chlorhexidine MW and painkiller
Sunscreen
Ice pack for 90 minutes
Acyclovir cream or zinc oxide cream
Oral acyclovir if frequent or recurrent intraoral
together with topical corticosteroid
Herpetic whitlow
It is a painful infection that affects more fingers or thumbs
HSV-1 whitlow affects dental or medical workers exposed to
oral secretions
It occurs in thumb sucking children due to autoinculation
Adults may got it following contact with HSV-2 infected
genitals
The skin of infected fingers become swollen and reddened
with fever and swollen lymph nodes
Vesicles initially form individually then merge together
The lesion usually heals in 2-3 weeks
Aetiology
Acyclovir cream
Chickenpox
varicella
1ry infection that spreads by direct contact or by air
Incubation period takes 1-3 weeks after exposure to develop
Most common between the ages of 2-8 yrs
It is contagious 1-5 days before skin rash appears and
continues until all blisters crust over forming scabs
Presents in the mouth as oral ulcers mainly of the oropharynx
Most common in winter and spring as an epidemic every 3 yrs
Following 1ry infection the child becomes immune
Aetiology
MW
Painkillers or antihistamines
Oral acyclovir in adults
to be initiated early
Herpes zoster
shingles or zona
Once chickenpox is resolved, VZV becomes latent in ganglia
Reactivated virus travels down nerve axon causing a painful rash
Affects more thoracic region
Only 30% affects trigeminal nerve
Most common branch to be involved is the ophthalmic
The pain may be extreme in the affected dermatome
Skin rash presented as a belt-like pattern that is limited to one
side of the body and does not cross the midline
Oral lesions appear if maxillary or mandibular branches involved
Patients older than 60 yrs are prone to postherpetic neuralgia
There is a risk of developing cancer after herpes zoster infection
It is extremely rare for patients to suffer more than 3 recurrences
Aetiology
VZV-specific IgM
antibody during
infection
Exclude malignancy and immune defect
Treatment
Clinical findings
Treatment
ifprednisolone and
acyclovir started within 3
days
Hand, foot and mouth disease
It is a childhood illness
Affects children aged 10 years and under
It is moderately contagious
Spread through direct contact with mucus, saliva or faeces
Occurs in small epidemics during summer and autumn
months
Should not be confused with foot and mouth disease of
animals
It manifests as painful vesicles on soles of feet and palms of
hand
Symptomatic
Antipyretics
Topical anaesthetics
(for painful ulcers!)
Herpangina
mouth blisters
It is a painful mouth infection, most common in children
Very contagious
Can be asymptomatic
Symptoms are usually high fever and sore throat
Ulcers form in the back of mouth, particularly soft palate
Lesions heal in 7-10 days
Aetiology
Supporative
Hydration
Antipyretics
Topical anaesthetics
Focal epithelial hyperplasia
Heck’s disease
BY HPV 13 or possible HPV 32
speial for Czech!
One of the most contagious oral papillary
lesions (also herpangina is very contagious)
40% of children can be affected in isolated populations (??)
Endemic among children, but lesions eventually disappear
Sites more affected include labial, buccal, and lingual mucosa
Lesions are papillary (??) but smooth-surfaced and flat-
topped
DD from squamous papilloma, VV, and condyloma
Lesions cluster and takes on a cobblestone or fissured
appearance
No case has been reported to transform into carcinoma
It may be an oral manifestation of AIDS
Aetiology
Excisional biopsy
Treatment
It is caused by EBV
Saliva is the primary method of transmitting mono
Oral ulcers
Petechial haemorrhages
Enlarged tonsils
Amoxicillin
non-allergic
rash
Amoxicillin rash
Diagnosis
Self-limiting
NSAIDs for fever
Valacyclovir
ethambutol,
pyrazinamide)
Syphilis
It is a sexually transmitted infection of 3 distinct stages:
1ry phase- highly contagious; tongue is second to lip as site
for chancre which is painless (like SLE AND PRIMARY TB) ,
hard and punched out. Associated
cervical glands are hard and non-tender; lasts one week
3rd phase- less contagious than 2ry, but can be fatal. Presents as
gummas known as granulomas on hard palate or dorsum tongue. In
addition to a leukoplakia of dorsum tongue known as
syphilitic
glossitis which is premalignant
Aetiology
Candida albicans
Precipitating factors-
(smokers, AB, steroids, immunosuppressive, CT(???),
irradiation, xerostomia, leukaemia, AIDS, malnutrition, DM,
neonates)
Thrush
Thrush
Angular cheilitis
Diagnosis
iron or
carbohydrate-rich diets,
associated with
erythematous candidiasis
Median rhomboid glossitis
Median rhomboid glossitis
Diagnosis