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Traumatic Erythema
The condition occurs when a traumatic event results in hemorrhage within the oral tissues.
Clinical features - Traumatic erythema can present as an ecchymosis (multiple small bruises) or a hematoma (a single larger bruise). Clinically, it appears as an irregular, usually flat, area with a bright or deep red color. The tongue, the lips, and the inside surfaces of the cheeks are the most common areas affected. Diagnosis is based on clinical appearance and patient history.
Treatment - None required.
Thermal Burn
Thermal burns to the oral mucosa are relatively common, usually due to contact with very hot foods and liquids.
Clinical features - The condition appears as a red, painful area that may undergo desquamation (peeling away of superficial layer of skin), leaving erosions. The lesions heal spontaneously in about a week.
Treatment - None required.
Geographic Tongue
Geographic tongue presents as multiple, well-defined patches of redness surrounded by a thin, raised whitish border. Usually, the lesions persist for a short time in one area, disappear within a few days, and then develop in another area. The top surface (dorsum) of the tongue is the most common area of development.
Treatment - None required.
Median Rhomboid Glossitis
Median rhomboiod glossitis is a relatively rare condition that only occurs on the top surface of the tongue.
Cause - Believed to be developmental, though Candida albicans is also thought to play a role.
Clinical features - The condition presents as a well-demarcated red rhomboid-shaped area along the middle of the top surface of the tongue. The surface of the lesion may be smooth or lobulated.
Treatment - None required.
Denture Stomatitis
Denture stomatits, or sore mouth, is a frequent condition in patients who wear dentures continuously or for long periods of time.
Cause - Mechanical irritation from the dentures, candida albicans, or a tissue response to microorganisms living beneath the dentures.
Clinical features - The condition is characterized by diffuse redness, swelling (edema), occasionally bruising (petechiae) and white spots that represent accumulations of candidal hyphae. The condition is almost always located in the denture-bearing area of the maxilla (palate). The condition is usually asymptomatic.
Treatment - Improvement of denture fit , oral hygiene, and topical antimycotics.
Squamous Cell Carcinoma
The early stage of squamous cell carcinoma may present as an asymptomatic, atypical red patch. The clinical features are identical to erythroplakia. In these early stage, a biopsy should be taken to confirm diagnosis. For more information on squamous cell carcinoma, see our section on
oral cancer.
Erythroplakia
The condition is defined as a red, nonspecific patch or plaque that cannot be classified as any other disease.
Cause - unknown
Clinical features - It appears asymptotically as a fiery red, demarcated plaque with a smooth and velvety surface. The floor of the mouth, soft palate area, and tongue are the most common sites of involvement. It occurs most frequently between the ages of 50 and 70. Over 91% of erythroplakias histologically demonstrate early invasive squamous-cell carcinoma at the time of diagnosis.
Treatment - surgical excision.
Contact Allergic Stomatitis
The condition is a rare acute or chronic allergic reaction.
Cause - Denture based materials, restorative materials, mouthwashes, toothpastes, foods, chewing gums, and other substances may be responsible.
Clinical features - The affected mucosa presents with diffuse redness and swelling and occasionally small vesicles and erosions. A burning sensation is a common symptom. In the chronic form, white lesions may be seen in addition to redness.
Laboratory tests - mucosal and skin patch tests.
Treatment - Removal of suspected allergens, topical or systemic steroids, antihistamines.
Hemangioma
The condition is a relatively common benign proliferation of blood vessels that primarily develops during childhood.
Cause - Developmental
Clinical features - Two main forms of the condition are recognized - capillary and cavernous. The capillary form presents as a flat red area consisting of numerous small capillaries. Cavernous hemangioma appears as an elevated lesion of a deep red color, and consists of large diluted sinuses filled with blood.A characteristic sign of hemangioma is that the red color disappears on pressure, and returns when the pressure is released.
Treatment - Surgical excision, cryotherapy, or laser.
Lupus Erythematous
The condition is a chronic immunologically mediated disease.
Clinical features - Two main forms of the disease are recognized - discoid and systemic. The oral lesions are characterized by a well-defined central red area surrounded by a sharp elevated border of irradiating whitish striae.
Laboratory tests - direct immunofluorescence, histopathological examination.
Treatment - steroids, antimalarials.
Anemia
Oral manifestations of anemia are early and common and are characterized by a smooth, red tongue. a burning sensation, taste loss, angular chelitis (chaffing at the corners of the mouth) may also be noted.
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