Traumatic Ulcers Workup

  • Author: Glen Houston, DDS, MSD; Chief Editor: William D James, MD   more...
 
Updated: Jan 18, 2012
 

Procedures

  • Ulcerations without an etiology or those that persist despite therapy may need to be examined microscopically to exclude malignancy and other causes.
  • Some ulcers caused by trauma may resemble squamous cell carcinoma or granulomatous ulcers (eg, those resulting from deep fungal infections or tuberculosis). If the cause of the ulceration is not obvious at clinical examination or if no response to local therapy is noted, biopsy may be indicated to exclude these conditions. Also see Oral Manifestations of Systemic Diseases.
Next

Histologic Findings

Microscopic features include an area of surface ulceration covered by a fibrinopurulent membrane consisting of acute inflammatory cells intermixed with fibrin. The stratified squamous epithelium from the adjacent surface may be hyperplastic and exhibit areas of reactive squamous atypia. The ulcer bed is composed of a proliferation of granulation tissue with areas of edema and an infiltrate of acute and chronic inflammatory cells.

Previous
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Glen Houston, DDS, MSD  Chair, Professor, Department of Oral and Maxillofacial Pathology, University of Oklahoma Health Sciences Center

Glen Houston, DDS, MSD is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Academy of Oral Medicine, and American Dental Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Daniel Mark Siegel, MD, MS  Director, Procedural Dermatology Fellowship Program, Clinical Professor of Dermatology, Department of Dermatology, State University of New York Downstate

Daniel Mark Siegel, MD, MS is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American College of Physician Executives, American Society for Dermatologic Surgery, American Society for MOHS Surgery, and International Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS  Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Butler J, Fleming P, Webb D. Congenital insensitivity to pain--review and report of a case with dental implications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Jan 2006;101(1):58-62. [Medline].

  2. Bouquot JE. Common oral lesions found during a mass screening examination. J Am Dent Assoc. Jan 1986;112(1):50-7. [Medline].

  3. Baroni A, Capristo C, Rossiello L, Faccenda F, Satriano RA. Lingual traumatic ulceration (Riga-Fede disease). Int J Dermatol. Sep 2006;45(9):1096-7. [Medline].

  4. Ceyhan AM, Yildirim M, Basak PY, Akkaya VB, Ayata A. Traumatic lingual ulcer in a child: Riga-Fede disease. Clin Exp Dermatol. Mar 2009;34(2):186-8. [Medline].

  5. Padmanabhan MY, Pandey RK, Aparna R, Radhakrishnan V. Neonatal sublingual traumatic ulceration - case report & review of the literature. Dent Traumatol. Dec 2010;26(6):490-5. [Medline].

  6. Gilvetti C, Porter SR, Fedele S. Traumatic chemical oral ulceration: a case report and review of the literature. Br Dent J. Apr 10 2010;208(7):297-300. [Medline].

  7. Maron FS. Mucosal burn resulting from chewable aspirin: report of case. J Am Dent Assoc. Aug 1989;119(2):279-80. [Medline].

  8. Rees TD, Orth CF. Oral ulcerations with use of hydrogen peroxide. J Periodontol. Nov 1986;57(11):689-92. [Medline].

  9. Shetty K. Hydrogen peroxide burn of the oral mucosa. Ann Pharmacother. Feb 2006;40(2):351. [Medline].

  10. Rawal SY, Claman LJ, Kalmar JR, Tatakis DN. Traumatic lesions of the gingiva: a case series. J Periodontol. May 2004;75(5):762-9. [Medline].

  11. Ozcelik O, Haytac MC, Akkaya M. Iatrogenic trauma to oral tissues. J Periodontol. Oct 2005;76(10):1793-7. [Medline].

  12. Hirshberg A, Amariglio N, Akrish S, et al. Traumatic ulcerative granuloma with stromal eosinophilia: a reactive lesion of the oral mucosa. Am J Clin Pathol. Oct 2006;126(4):522-9. [Medline].

  13. Ganesh R, Suresh N, Ezhilarasi S, Rajajee S, Sathiyasekaran M. Crohn's disease presenting as palatal ulcer. Indian J Pediatr. Mar 2006;73(3):229-31. [Medline].

  14. Edlich RF, Farinholt HM, Winters KL, Britt LD, Long WB 3rd. Modern concepts of treatment and prevention of electrical burns. J Long Term Eff Med Implants. 2005;15(5):511-32. [Medline].

  15. Hashem FK, Al Khayal Z. Oral burn contractures in children. Ann Plast Surg. Nov 2003;51(5):468-71. [Medline].

  16. Hitchings A, Murray A. Traumatic ulceration mimicking oral squamous cell carcinoma recurrence in an insensate flap. Ear Nose Throat J. Mar 2004;83(3):192, 194. [Medline].

  17. Gallego L, Junquera L, Llorente S. Oral carcinoma associated with implant-supported overdenture trauma: a case report. Dent Traumatol. Feb 2009;25(1):e3-4. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.