: For example, recurrent aphthous ulcers are more common in young adults and peptic sores are more common in middle-aged and elderly people.

The floor of the mouth - the U-shaped area on the belly of the tongue, the triangular area inside the corner of the mouth, and the soft and soft complex are known as the three major danger areas of the oral mucosa.

Cross-sectional comparison of clinical lesions for diagnosis and differential diagnosis

Pathological examination

In addition to tissue sections, immunohistochemistry and molecular pathology may also be involved.

Clinically necessary therapeutic diagnosis

l) Treat the same disease with different treatments

2) Treat different diseases with the same treatment

3) Systemic treatment of local diseases

4) Integrated Traditional Chinese and Western Medicine Treatment

Most oral mucosal diseases have a good prognosis

Risk of developing cancer

Signs of serious systemic disease

basal layer

stratum spinosum

granular layer

corneum

non-keratinocytes

The basement membrane is not a membrane in the ultrastructure, but a fibrous complex composed of collagen fibers of connective tissue connected with the dense layer and the transparent layer, which is called the basement membrane complex (object).

The basement membrane mainly has the following functions

The lamina propria plays a role in supporting and nourishing the epithelial layer.

The submucosa is loose connective tissue that contains glands, blood vessels, lymphatic vessels, nerves, and fatty tissue. It is mainly distributed in the covering mucosa. However, there is no submucosal layer in the heels of teeth, most areas of the hard cheeks, and the back of the tongue.

The submucosa provides nutrition and support to the lamina propria

Physical and chemical barriers

immune barrier

mucin in saliva

Lysozyme in saliva

pain

touch

temperature

Taste

Temperature adjustment

secretion

The organelles responsible for cell metabolism (nucleus, mitochondria, ribosomes, endoplasmic reticulum) will gradually decrease

The products of keratin formation (tension filaments, keratin bodies, and transparent keratin granules) will gradually increase

After reaching the stratum corneum, the transparent horny granules are closely connected with the tension filaments to form the stratum corneum, at which time almost all other cell structures disappear.

In basal cells, keratin filaments are loosely arranged in bundles, mostly distributed around the nucleus and parallel to the long axis of the cell.

In spiny cells, tension filaments gradually increase and become denser, interwoven into a network structure surrounding the nuclear membrane, running through the entire cytoplasm, and inserting desmosomes to form a scaffolding structure

In granulocytes, keratin filaments are associated with hyaline granules and interact with phosphorylated histone-rich proteins

After reaching the cornified layer cells, the histone-rich proteins are dephosphorylated and become basic proteins in the cornified layer. The keratin filaments gather into bundles, are embedded in the basic proteins, and are surrounded by thickened cell membranes, thus forming a complete keratin. stromal epithelium

28~75 days

28~40 days

5~16 days

2~14 days

thickness becomes thinner

Decreased cell density

Reduced cellular level

thickening of corneum

Cell volume becomes smaller

Decreased number of Langerhans cells

Decreased cellular content in the lamina propria and submucosa,

Fibroblasts shrink in size and number

Increased insoluble collagen fibers

Collagen degeneration and rupture

Minor salivary glands appear significantly atrophied, secretion decreases, and are replaced by fibrous tissue

Saliva secretion gradually decreases

The body's immune function, especially cellular immune function, is significantly reduced

The proliferative response of peripheral blood T lymphocytes to various antigen stimuli gradually weakens

The concentration of defense protein components such as mucin and lgA decreases to varying degrees with age.

Reduced taste sensitivity

Decreased spatial perception and two-point discrimination ability

Dilation, proliferation and congestion of blood vessels in the lamina propria of the mucosa

Caused by melanocyte deposition in the basal layer of the epithelium

Or there is hemosiderin from old bleeding in the lamina propria of the mucosa, making the surface black.

Some metal particles are deposited in the mucosa

A papule is a small solid protrusion on the mucous membrane, about the size of a pinhead, usually less than 1cm in diameter - Lichen plana

Base shape is round or oval

Surface shape can be pointed, round or flat

Under the microscope, epithelial thickening, serous exudation, and inflammatory cell infiltration can be seen

Color is off-white or red

Leaves no trace after fading

Plaque is also translated as papule. Most of them are formed by the dense fusion of multiple papules, with a diameter greater than 1cm. Their boundaries are clear and vary in size.

Slightly raised and firm lesions

white or off-white

The surface is relatively smooth or rough

Fissures can be seen dividing the lesions.

If the diameter of the damage is more than 1cm, it is called a large one.

abscess

blood scar

restaurant

The location of the cook is within the epithelium

basal subepithelial tract or subepithelial tract

simple rash

childhood scars

Line with blurred edges

Fibroids or grief

Such as riboflavin deficiency caused by cleft corner of the mouth

Bleeding turns dark brown

Pathological death of local cells in the body

Large-scale necrosis and decay due to the action of rotten parasites are called gangrene

Oral hygiene, periodontal health, dental health, and possible restorations, etc.

In order, they are lipstick, labial mucosa, buccal mucosa, floor of the mouth and tongue abdominal mucosa, tongue mucosa, cervical mucosa, pharyngeal mucosa and dental limit.

Hematology tests

Immunological examination

microbiological examination

exfoliative cytology

biopsy

Immunohistochemical examination

molecular biology

Urine routine

Stool routine

Film degree exam

Classification

symptom

1. Primary herpetic stomatitis

2 Recurrent herpetic stomatitis

Epithelial cells undergo ballooning degeneration and reticular liquefaction, forming a cyst within the epithelium.

There are eosinophilic virus bodies, also called viral inclusion bodies, in the nuclei of balloon-shaped cells. They are mostly located at the bottom of restaurants.

Three changes can be seen: ground glass nuclei, multinucleated syncytia, and intranuclear inclusions.

Clinical symptoms

Herpetic gingivostomatitis and stomatitis

trigeminal herpes zoster

Hand, foot and mouth disease

herpangina

erythema multiforme

systemic treatment

topical treatment

supportive care

Traditional Chinese Medicine

Banned hormones

Oral respiratory tract transmission, mainly avoid contact with patients

Unilateral

along the nerve

clusters of small blisters

neuralgia

Chickenpox in children, herpes zoster in adults

Thoracic and abdominal>lumbar>trigeminal nerve

antiviral drugs

Pain relief

hormone

neurotrophic drugs

immunomodulatory drugs

topical treatment

The first one

second branch

The third branch

Ramsay-hunt syndrome

Staphylococcus aureus

viridans streptococci

Hemolytic Streptococcus

pneumococci

Gray-white-yellow-brown pseudomembrane

antibacterial drugs

vitamins

Traditional Chinese medicine mouthwash

Tuberculous sores (primary syndrome)

tuberculous ulcer

Lupus vulgaris

Tuberculous nodules may be seen in connective tissue

Early, regular, full course, appropriate amount and combined use of anti-tuberculosis drugs

Commonly used anti-tuberculosis drugs

Oral tuberculosis treatment

Clostridium and spirochetes

Incorporate other bacteria

Mainly tissue necrosis (necrosis)

Nucleus and cytoplasm lysis

Acute phase treatment

Systemic anti-infection

systemic supportive care

Chinese medicine treatment

Prognosis and outcome

prevention

Opportunistic pathogens

unicellular yeast-like fungi

Gram stain positive

Intolerant to heat, loves acid and alkali

The appropriate pH is 4~6

Complete cell wall, cell membrane, cytoplasm and nucleus

biphasic fungi

Toxicity of pathogenic bacteria

Host defense capabilities and susceptibility factors

The relationship between candida infection and oral leukoplakia

pseudomembranous type

atrophic

Proliferative type

Related diseases

thickened parakeratotic epithelium

Hyphae can be seen in the outer 1/3 of the cornified layer or epithelium

epithelial acanthosis

Epithelial spikes are round

The basement membrane is partially destroyed by inflammation

HE staining is not very clear

Strongly positive PAS

There are congested capillaries and a large number of lymphocytes, plasma cells and neutrophils infiltrating in the connective tissue.

smear method

isolation culture method

Biopsy

Immunization method

molecular biology methods

Pathogen identification

Microscopic hyphae, spores, microabscesses

Mainly local treatment

antifungal drugs

Comprehensive Treatment

Surgical treatment

No hormones, broad-spectrum antibiotics and hydrogen peroxide are ineffective

candidiasis

Cryptococcosis

Aspergillosis

mucormycosis

sporotrichosis

Penicillium maneffei

Histoplasmosis

Paracoccidioidomycosis

blastomycosis dermatitis

Candida accounts for more than 80%

Except Candida spp.

Large-scale, long-term or combined use of multiple broad-spectrum and highly effective antibiotics

use of hormones or immunosuppressants

Elderly patients

Serious basic diseases, such as hematoma, malignant tumors such as lung cancer and liver cancer, chronic nephritis, uremia, kidney transplantation, chronic obstructive pulmonary disease, pimples, cerebral hemorrhage, diabetes and AIDS, etc.

organ transplant

Various catheter interventional treatments such as organ cannulation and urinary catheterization

radiotherapy, chemotherapy

The route of infection is usually hematogenous dissemination and ascending infection

(1) Preventive treatment

(2) Empirical treatment

(3) Preemptive treatment

(4) Targeted treatment

Class 3 drugs can be used to treat deep fungal infections

In addition to Zhaconazole and Itraconazole, commonly used clinical drugs against deep fungal infections include

Type 1 allergy (reagin type)

Type 1I allergic reaction (cytolytic or cytotoxic)

Sichuan type allergy (immune complex type)

Antigen-specific sensitization effector T cell-mediated

The immune substances involved in causing the reaction are not humoral antibodies but sensitized lymphocytes

Good hair on upper lip

Occurs in the epiglottis causing suffocation

Lips, tongue, cheeks, eyes, face, earlobes, throat, etc.

The vulva and gastrointestinal tract mucosa can also be involved

food

drug

flora and fauna

physical factors

Mental factors such as emotional excitement

Viruses, bacteria, parasites

genetics

History of exposure or recurrence

periapical abscess

cellulitis

A large amount of vitamin C 500~1000mg

10% calcium gluconate

Dexamethasone 5~10 mg intravenously

Oral anti-allergy medications

For severe cases, hormones can be used

When larynx is edema

antibiotics

antipyretic analgesics

Hypnosis and anti-epilepsy

Sulfonamides

A small number of Chinese patent medicines

The first time requires an incubation period (4~20 days)

blister rupture erosion ulcer

Skin: Commonly occurs around the mouth

The most common lesions are round erythema

The location of the lesion is fixed

Medication history, allergy history

sudden acute inflammation

Improvement after stopping medication

polymorphous exudative erythema

herpetic stomatitis

Discontinue medication

High dose vitamin C

anti-allergy medicine

hormone therapy

Antibiotics fight infections?

Ethacridine and chlorhexidine topical application

It takes at least 7 to 10 days for local antibodies to form after a certain incubation period after exposure to the substance.

Reaction usually takes 48 to 72 hours after repeated exposure.

Denture base (methacrylic acid, engraving alloy, diamond alloy)

Dental fillings (silver alloy, resin)

Inlay (gold, silver)

Toothpaste, lipstick, chewing gum, clove oil, dish detergent, etc.

Histopathology shows acute inflammation

Tissue edema, blood vessel dilation, and inflammatory cell infiltration can be seen

When showing a fresh-like reaction, mild partial hyperkeratosis of some epithelium can be seen, the granular layer is obvious, the basal layer is thickened or thinned, the basal cells are liquefied and degenerated, lymphocyte infiltration can be seen under the epithelium, and a small amount of eosinophils and neutrophils can be seen. Granulocyte, plasma cell infiltration and infiltration around small blood vessels.

Remove suspected allergens first

medical treatement

prevention

nonspecific inflammation

Intraepithelial and intercellular edema

There is edema in the connective tissue and infiltration of inflammatory cells

Dilation of blood vessels, swelling of vascular endothelial cells and thickening of blood vessel walls, and infiltration of mixed inflammatory cells mainly composed of lymphocytes around blood vessels

Mild aphtha

Severe aphtha

stomatitis type aphtha

l0~l4 days

l0~l4 days

>14 days, can be 1~2 months or longer

Oro-eye-genital triad

Erythema nodosum, folliculitis, positive acupuncture reaction

Systemic immune system diseases

Consistent with mechanical trauma factors

Deep, large, crater-shaped ulcer with raised edges

progress rapidly

no self-limiting

The edges are uneven, rat-like, and curled toward the center.

Exudate, mulberry granuloma beneath the exudate

Acidophilus bacteria were seen under the microscope, not self-limiting

child

All large, medium and small blood vessels throughout the body, of which veins are the most affected

Perivascular lymphomonuclear cell infiltration

Similar to recurrent aphthous ulcer

70%~99% of the first symptoms will eventually occur in 100% of patients

Approximately 75% of patients develop

The lesions are basically similar to oral ulcers

The incidence rate is high, up to 80%, and the manifestations are diverse

Erythema nodosum, eruptions, papules, scablike rashes, erythema multiforme, annular erythema, necrotizing tuberculosis eruption-like lesions, large scar necrotizing vasculitis, Sweet's disease-like skin lesions, pyoderma, etc.

Particularly valuable for diagnosis

Approximately 50% of patients are affected

The most common eye disease is uveitis

Keratitis, exanthematous conjunctivitis, scleritis, choroiditis, retinitis, optic nerve papillitis, necrotizing retinal vasculitis, fundus hemorrhage, etc.

25% to 60% of patients have

Presents as relatively mild localized, asymmetric arthritis

The incidence rate is about 5%~50%

Neuroautotic disease

The incidence rate is 10%~50%

Also known as intestinal Behcet's disease (

The entire digestive tract from the mouth to the anus can be affected. Ulcers can be single or multiple and vary in depth.

About 10% to 20% of patients are complicated by large and medium vasculitis, which is the main cause of death and disability.

The basic lesion of this disease is vasculitis, which can affect both large and small blood vessels throughout the body.

About 5%~10%

most prominent symptoms

starter

second

Desmoglein (Dsg)

Oral mucosa

skin

Other parts

It is rare. Because its antigenic components are mostly consistent with those of vulgaris, it is also considered to be a subtype of vulgaris.

Damage is rare, and even if it occurs, it is mostly small and superficial erosion that is not obvious.

It usually occurs on the head, face and upper chest and back. Water scars often occur on the basis of erythema, Nissl's sign is positive, the walls are thinner and more susceptible to rupture, and the superficial erosion surface is covered with yellowish-brown, greasy roundworms and scales, such as fallen leaves.

The original ingredients are consistent with those of the deciduous type, and the disease is considered to be a subtype of the deciduous type.

Loose single spiny cells or spiny cells distributed in clusters

Consistent with direct immunofluorescence display

The drug of choice for treating hemorrhoids

If no new damage occurs within 1 to 2 weeks of treatment, it indicates that the dose is sufficient. Otherwise, the dose needs to be increased or other immunosuppressants need to be combined.

If the dose of prednisone is high, reduce the original dose by 10% every 1 to 2 weeks.

When the dose of glucocorticoids is reduced to a very small dose, it can be maintained for a long time. The maintenance dose is prednisone 0.2 mg/(kg · d) or 10 mg/d.

Patients who do not respond well to glucocorticoids

Commonly used first-line immunosuppressants include thiazolopine (AZA) and mycophenolate mofetil (MMF).

benign mucosal leukemia

BP180

BP230

Laminin 332

Laminated eggs from 311

Two subunits of a6 positive integrin

Oral mucosa, especially the heel of the teeth, repeatedly scars for several months or years, and does not heal.

low risk type

High risk type

Oral mucosa

Eye

skin

Other parts

There is a sac or fissure between the epithelium and connective tissue, which is the subepithelial cavity.

The connective tissue is infiltrated by lymphocytes, plasma cells and eosinophils and dilated blood vessels are seen.

direct immunofluorescence

Indirect immunofluorescence test

Oral mucosal damage is often the first clinical manifestation

Lipstick lesions often appear first

Oral mucosal damage is similar to common pimples, such as large-scale erosion, positive Nissl sign, positive peel test and positive probe test, etc.

Skin damage is often delayed from mucosal damage by days to months

polymorphism

Easily visible in oral mucosa), which may coexist with acantholysis or occur alone

IgG (or with C3) is deposited between spinous cells, and some patients also have IgG (and/or C3) deposition in the basement membrane zone.

When large tension scars appear on the oral mucosa, small white stripes can be seen in the form of a network. Water scars are scattered and can break down to form ulcers.

Water scars often appear suddenly after an acute attack of generalized lichen planus

Epithelial hyperkeratosis, thickening of the granular layer, irregular thickening or atrophy of the spinous cell layer, vacuolation or liquefaction degeneration of basal cells, band-like infiltration of lymphocytes in the superficial layers of connective tissue, and colloid bodies can be seen

In subepithelial ulcers, moderately dense infiltration of lymphocytes, histiocytes and eosinophils can be seen around the superficial blood vessels of the connective tissue, but the basal cells above them are mostly intact due to no liquefaction degeneration.

IgG and C3 are deposited linearly in the basement membrane zone in both leprosy and non-lethal lesions.

Followed by non-anti-inflammatory drugs

The specificity is not high and it is difficult to distinguish it from other subepidermal macroscopic diseases.

Skin lesions are mostly generalized and polymorphic

May only cause oral damage without skin damage

Most of the disease occurs in preschool years, with an acute onset, periodic attacks and remissions, and a self-limiting course.

Skin lesions are widely distributed and symmetrical

Commonly seen around the mouth, extended sides of limbs, groin and vulva

Tension hydromas appears on normal skin or erythema, negative Nissl sign, accompanied by varying degrees of pain and itching

May be accompanied by mucosal damage, manifested as oral mucosal erosion, nasal congestion and bleeding, and conjunctivitis

Uniform linear deposition of lgA on the skin or mucosal basement membrane, sometimes accompanied by deposition of IgG and C3

There are a large number of T lymphocytes infiltrating in the epithelial lamina propria in a dense band-like manner.

history of trauma

Middle-aged women have a higher incidence of OLP

Viral infection may be one of the causative factors

Microcirculation disorders and hyperviscosity are related to OLP

The disease has been found in several people in a family; some patients have a family history

Diabetes, hepatitis, hypertension, digestive tract disorders

Wickham striae similar to skin lesions

Cheeks are most common

When irritated by spicy, hot, sour, or salty food, the affected area may become sensitive and burn.

Reticulated type

plaque type

atrophic

Water scar type

erosion type

Papular type

Tongue

lips

Heel

palate

Flat polygonal papules, purple-red in color, with thin scales on the surface and a waxy sheen

It is often symmetrical, but it is rare for patients to have ten finger (toe) nails affected at the same time. The nail body becomes thin and dull, and there are dents when pressed.

Direct immunofluorescence method shows fine granular fluorescence, forming a fluffy fluorescent band along the basement membrane area.

Drugs that cause drug-induced liver damage

contact lichen-like lesions

graft-versus-host reaction liver-like lesions

At present, the differential diagnosis of OLP and OLL is mainly based on clinical criteria and histopathological criteria.

Plaque OLP and leukoplakia are sometimes difficult to differentiate, especially lesions on the back of the tongue

Histopathological examination is of great significance in the identification of

Mixed oral erythema is easily confused

Lacks distinct white stripes

Erythema multiforme appears on the skin. There is a small puddle in the center of the erythema. The appearance of the lesion looks like an "iris" or a "target ring".

Glucocorticoids: 0.05% azolone acetate and 0.05% clobetasol gel are highly safe and effective when applied locally.

Vitamin A acid

antifungal drugs

Glucocorticoids

immunosuppressant

immune booster

Antioxidants

Chinese patent medicine

other

It is related to many factors such as ultraviolet radiation, trauma, infection, and drugs.

certain drugs

certain foods

Cold stimulation, mental stress

Sometimes, epithelial nail process proliferation and elongation can also be seen

Fissures and small sores may form between the epithelium and the lamina propria, and the basement membrane is not clear.

There is a continuous green fluorescent band with uneven thickness in the basement membrane area, which is called the "lupus band"

Higher odds of transition to SLE

Round or oval erythematous erosions are concave and disk-shaped, with slightly raised edges. There is redness or telangiectasia around the redness, and there are short white streaks arranged radially around the redness.

The vermilion mucosa of the lower lip is a common site for DLE

Lesions are often asymmetrical

Good hair, face and other exposed parts

Compared with discoid lupus erythematosus, the diagnosis of SLE requires a combination of clinical diagnostic criteria and immunological criteria

The skin lesions of lichen planus are symmetrical and occur on the extensor sides of the limbs or the trunk.

Light purple polygonal flat papules, the patient feels strong itching

Oral mucosal lesions are irregularly shaped self-colored stripes or plaques, and the lesions on the vermilion area will not exceed the vermilion border.

Topical corticosteroids

Immunosuppressants such as cyclosporin and tacrolimus

Hydroxychloroquine

Tripterygium wilfordii and Kunmingshan crabapple

Glucocorticoids

thalidomide

ethanol

tobacco

Local irritating factors such as cheek-biting habits, misaligned teeth, sharp edges formed by uneven wear of teeth, residual roots and crowns, dental calculus, etc., can all irritate the oral mucosa and are related to the occurrence of oral leukoplakia.

trace elements

microcirculatory changes

genetic susceptibility

fat-soluble vitamin deficiency

Vitamin A

Vitamin A acids

�Carotene

other

Homogeneous oral leukoplakia in the danger zone as well as caressing, granular and ulcerative forms of oral leukoplakia

Photodynamic therapy, laser therapy, cryotherapy, etc.

In this disease, there are insufficient Odland bodies between cells and an increase in desmosomes in the lesion area, which may be the reason for the accumulation of cells on the epithelial surface and the spongy appearance.

Residual roots, residual crowns, and sharp edges of maxillary and mandibular posterior teeth

Malocclusion

Bad restoration

smoking

Occurs in the mucosa of the hard cheeks and the heels of the teeth, and is diffusely distributed as gray-white or milky-white lesions with scattered red dots, mostly caused by long-term smoking.

Nicotinic (nicotine) stomatitis

Patients may have subjective symptoms such as dryness and roughness

Homogeneous erythema

intermittent erythema

granular erythema

Lesions show loss of autofluorescence

Positive toluidine blue staining indicates the malignant tendency of the lesion.

Once oral erythema is diagnosed, radical surgery should be performed immediately

Surgical resection is more reliable in clinical efficacy than cryotherapy

Factors such as eating chili peppers, smoking, and drinking alcohol can aggravate submucosal fibrosis.

Deficiency of vitamins A, B and C, low serum iron and selenium and high serum zinc and copper

It may be related to allergic reactions caused by exogenous antigen stimulation such as palm alkaloids

Some patients have microcirculatory disorders and blood rheology abnormalities, etc.

Blood vessels may be dilated and congested, with neutrophil infiltration.

Including anti-inflammation, anti-fibrosis, improvement of ischemic state and antioxidant, etc.

Glucocorticoids

Antifibrotic drugs and proteolytic enzymes

peripheral vasodilators

Antioxidants and nutrients

hyperbaric oxygen therapy

Chinese medicine treatment

It often occurs on the upper lip or lower lip alone, but it can also occur on both lips, but it is rare.

Sometimes the swelling gives the lip a lobed appearance. Lips and surrounding skin may appear red or dark red

The buccal mucosa is swollen and proliferated, showing lobulation or thickening. The thickened mucosa can easily be bitten and form traumatic ulcers.

The heel tissue can be extensively proliferated and swollen, and the surface may be smooth or have small nodules.

The swelling is mostly in the lower half, with a few visible swellings in the eyes, face, cheeks, and nose.

Swelling can be persistent or temporary

Facial nerve paralysis often occurs before facial swelling

mental factors

abdominal trauma

envirnmental factor

There are systemic symptoms such as low fever, fatigue, and weight loss in the afternoon. Anemia may also be caused by malabsorption of iron, vitamin B12, and folic acid due to lesions and dysfunction of the digestive tract.

The patient had recurrent abdominal distension, abdominal pain, abdominal masses, increased stool frequency, and paroxysmal cramps, diarrhea, and bloody and purulent stools in the right lower abdomen.

In the late stage, intestinal obstruction or even intestinal perforation may occur, resulting in severe abdominal pain, bloating, vomiting, constipation, etc.

Oral lesions occur in about 10% of cases

Formation of linear or aphthous ulcers

Granulomas, small nodules and heel hyperplasia may also form

Oral mucosa may also undergo cord-like hyperplasia, folds, granular, and gravel-like nodular hyperplasia.

The lips may become diffusely swollen and indurated

The heel of the tooth may also appear visibly red and granular on the surface.

Other lesions outside the digestive tract may include osteoarthritis, spondylitis, uveitis, skin erythematous nodules, pyoderma gangrenosum, etc. Disorders of intestinal function may also lead to disorders of uric acid metabolism and the formation of kidney stones.

It often occurs on the lips, cheeks, cheeks, teeth and heels, head and neck lymph nodes, jaws, salivary glands, etc.

The lip tissue thickens and swells, forming a giant lip. The skin in the swollen area is dark red, and nodules can be palpated, with a hard feeling.

Nodular swelling may also occur on the cheeks

Mucosal hyperplasia without conscious symptoms may also occur in the parotid mucosa.

Granulomatous lesions in the alveolar bone can also cause bone destruction and loose teeth.

Parotid glands are often affected bilaterally

All systems of the body can be affected, with the lungs most commonly affected, followed by the eyes, skin, and lymph nodes.

Patients may have a cough or be asymptomatic, and in severe cases may develop pulmonary insufficiency.

Eye diseases include chronic iridocyclitis and uveitis

The liver and spleen are enlarged, and organs such as the heart and kidneys are also damaged.

When the nervous system is invaded, paralysis occurs, mostly in the facial nerve.

Skin lesions often appear as dark red papules, nodules or erythema nodosum, distributed on the face and limbs

The course of the disease is slow, and it may gradually subside over several months or years, leaving behind pigmented spots.

Round or oval body with lamellar calcification on the periphery, dark blue in HE staining

autosomal dominant inheritance

Toothpaste or mouthwash containing allergenic substances, trauma, smoking, poor oral hygiene, bad mood, periapical lesions, excessive ultraviolet exposure

Characterized by marked hyperplasia of small glands

Hypertrophic and dilated labial gland ducts

Mucosal epithelial cells have mild intracellular edema

Ectopic mucus glands are seen in the submucosa

In purulent cheilitis glandularis, small abscess formation can be seen in the subepithelial connective tissue.

Good luck in middle age

simple glandular cheilitis

Superficial suppurative cheilitis glandularis

Deep suppurative cheilitis glandularis

Local injection of adrenocortical hormone drugs can be used in the swollen area of ​​the lip

acute actinic cheilitis

chronic actinic cheilitis

Diagnosis and treatment as early as possible

topical treatment

systemic treatment

physical therapy

Surgical treatment

prevention

The cause is unknown. May be related to long-term and sustained stimulation by temperature, chemical, and mechanical factors

non-specific inflammatory manifestations

chronic desquamative cheilitis

chronic erosive cheilitis

Lipstick is repeatedly dry, desquamated, painful, itchy, oozing and crusted

Depending on the course of the disease, it may be mild or severe, and is more likely to occur in cold and dry seasons.

Sjogren's syndrome

Cheilitis caused by diabetes

chronic actinic cheilitis

Differentiation of Candida cheilitis

Avoiding irritants is the primary treatment measure

Chronic desquamative cheilitis requires lip moisturizing

Caused by pathogenic microorganisms such as fungi, bacteria, and viruses

Too many teeth are missing or the entire mouth is severely worn

Patients suffering from long-term chronic diseases or weak constitution after radiotherapy or chemotherapy

scarlet fever in children

Herpes virus infection, Treponema pallidum infection, HIV infection

In the acute stage, the corners of the mouth are congested, red and swollen, with bloody or purulent secretions exuding, layers of dirty blood or pus, and obvious pain.

In the chronic stage, the skin and mucous membranes at the corners of the mouth are thickened and gray-white, accompanied by small horizontal lines or radial cracks, and the lips are red and cracked, but the pain is not obvious.

There are also other corresponding symptoms of primary diseases such as scarlet fever, rash, syphilis, and AIDS.

Based on the clinical manifestations of inflammation in the corner of the mouth and the results of microbiological examinations such as bacterial culture and candida direct microscopy

Fungal angular cheilitis often occurs simultaneously with fungal cheilitis

Targeted at different pathogenic microorganisms that cause infectious angular stomatitis, local treatment is mainly used

Fungal angular stomatitis can be treated with 2% sodium bicarbonate solution wet compress

Bacterial infectious angular stomatitis can be treated with chlorhexidine solution as a wet compress

Topical chlorhexidine solution can be used for eruptive angular stomatitis

Measures should be taken to eliminate the adverse environment that causes infectious angular stomatitis

Caused by iatrogenic trauma to the corner of the mouth, severe physical stimulation or certain bad habits

Unilateral damage to the corners of the mouth, fresh wounds of varying lengths

Old wounds may have ascariae, edema, and erosion.

Those caused by trauma may be accompanied by local tissue edema and subcutaneous congestion.

Clear history of trauma or prolonged oral treatment experience

Mainly local treatment

Local factors include sharp tooth tips, dental calculus, poor restorations, irritation such as eating spicy or hot food, and pharyngeal infection

Systemic factors include malnutrition, anemia, blood diseases, fungal infections, abuse of antibiotics, endocrine disorders, vitamin deficiency, etc.

It usually occurs on the back, tip and edge of the tongue. The lesions are mostly in the front 2/3 of the tongue and generally do not cross the lambdoid groove.

The central area shows filiform papillary atrophy and exfoliation-like appearance, and the mucosal surface is smooth, congested, red, and slightly concave.

The peripheral area shows thickening of the filiform papillae, which is distributed in the shape of yellow strips or arcs, about several millimeters wide, and forms a clear boundary with the surrounding normal mucosa.

non-specific inflammatory manifestations

Divided into atrophic zone and marginal zone

Intraepithelial spinous cell degeneration and edema, with microabscess formation similar to psoriasis

The shape is like gyri, leaf veins or branches, and can also occur on the lateral edge of the tongue

The mucosa at the bottom of the sulcus is continuous and complete, with no bleeding

The filiform papillae at the bottom of the sulcus are absent, and the filiform papillae at the lateral walls of the sulcus are sparse.

It may worsen with age, but progresses slowly

Often no symptoms

Followed by the tongue edge, tongue dorsum and tongue tip

Artificial cultivation is difficult to succeed

Reproduction is slow, taking 30 to 33 hours to divide once

Anaerobic microorganisms cannot easily survive without the human body

Particularly sensitive to temperature and drying

Sensitive to chemical disinfectants

Acquired (acquired) syphilis

Prenatally transmitted (congenital) plum blossoms

latent syphilis

early syphilis

late plum

It manifests as swelling and proliferation of vascular endothelial cells, and infiltration of a large number of lymphocytes and plasma cells around the blood vessels.

Granulomatous infiltrate with epithelioid cells and multinucleated giant cells, sometimes with necrotic tissue

Early detection, timely and regular treatment, the earlier the treatment, the better the effect.

The dosage is sufficient and the treatment course is regular

Sufficient time of follow-up observation is required after treatment

Examine and treat all sexual partners simultaneously

procaine penicillin

or jasmine penicillin

If you are allergic to penicillin, use the following medicines: doxycycline

procaine penicillin

or jasmine penicillin

If you are allergic to penicillin, use the following medicines: doxycycline

Sexually active young and middle-aged people

Mainly occurs in patients with a history of oral sex

It manifests as congestion and redness of the oral mucosa, which may have erosion or superficial ulcers, and is covered with a yellow-white pseudomembrane. The pseudomembrane is easy to wipe off, presenting a bleeding wound.

Common oral sex performers

More than 90% of infected people have no obvious symptoms, and a few patients experience dry throat, throat discomfort, burning or pain

Examination shows congestion of the pharyngeal mucosa and mucus or purulent secretions on the posterior pharyngeal wall.

It is suitable for the diagnosis of gonorrhea in men without complications. It is not recommended for pharyngeal, rectal and female cervical infections.

Currently the only recommended method for diagnosing gonorrhea

Typical colonies may appear, and the oxidase test is positive

Use PCR and other techniques to detect gonococcal nucleic acid positivity in various clinical specimens

The principle of timely, sufficient and regular medication use

Adopt different treatment plans according to different conditions

Follow up

Sexual partners should be examined and treated at the same time

Ceftriaxone 250mg, single intramuscular injection

Spectinomycin 2g, single intramuscular injection

Chlamydia infection cannot be ruled out, add anti-Chlamydia trachomatis infection drugs

Oral sex can occur in the mouth

gradually increase or increase

giant sharp

The appearance of subclinical infected skin and mucous membranes is normal. If 5% acetic acid solution is applied (acetic acid whitening test), a clearly defined area of ​​origin may appear.

Latent infection means that tissues or cells contain HPV but the appearance of the skin and mucous membranes is normal, the lesions are not hyperkerated and the acetic acid white test is negative.

It manifests as single or multiple small nodules, pedunculated or sessile, which can gradually enlarge or merge to form cauliflower-like or papillary excrescences, which are flesh-colored or pale in color.

Hyperkeratosis, flaky parakeratosis, epidermal acanthosis, basal cell hyperplasia, dilation of superficial dermal blood vessels, and infiltration of inflammatory cells mainly lymphocytes.

Focal, flaky and scattered vacuolated cells

HPV-specific genes (Ll, E6, E7 region genes)

acute pseudomembranous oral candidiasis