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Diagramatic representation of mucosal erosion (left), excoriation (center), and ulceration (right) Simplistic representation of the life cycle of mouth ulcers. An ulcer (/ ˈ ʌ l s ər /; from Latin ulcus, "ulcer, sore") [2] is a break in the skin or mucous membrane with loss of surface tissue and the disintegration and necrosis of epithelial tissue. [3]
Pain is worst in the days immediately following the initial formation of the ulcer, and then recedes as healing progresses. [4] If there are lesions on the tongue, speaking and chewing can be uncomfortable, and ulcers on the soft palate , back of the throat , or esophagus can cause painful swallowing . [ 4 ]
The mouth may act as a reservoir of Candida that reinfects the sores at the corners of the mouth and prevents the sores from healing. [citation needed] A lesion caused by recurrence of a latent herpes simplex infection can occur in the corner of the mouth. This is herpes labialis (a cold sore), and is sometimes termed "angular herpes simplex". [2]
A diagnosis can be made from clinical signs and symptoms, and treatment consists of minimizing the discomfort of symptoms. [5] It can be differentiated from herpetic gingivostomatitis by the positioning of vesicles - in herpangina, they are typically found on the posterior oropharynx, as compared to gingivostomatitis where they are typically found on the anterior oropharynx and the mouth.
Herpes labialis (cold sore) is a common cause of infectious cheilitis. [20] A lesion caused by recurrence of a latent herpes simplex infection can occur in the corner of the mouth, and be mistaken for other causes of angular cheilitis. In fact this is herpes labialis, and is sometimes termed "angular herpes simplex". [27]
Aphthous stomatitis (canker sores) is the recurrent appearance of mouth ulcers in otherwise healthy individuals. The cause is not completely understood, but it is thought that the condition represents a T cell mediated immune response which is triggered by a variety of factors.
Herpetic gingivostomatitis is an infection caused by the herpes simplex virus (HSV). The HSV is a double-stranded DNA virus categorised into two types; HSV-1 and HSV-2.HSV-1 is predominantly responsible for oral, facial and ocular infections whereas HSV-2 is responsible for most genital and cutaneous lower herpetic lesions.
In a few cases a sore mouth can develop, and if so pain is sometimes made worse by toothpastes, or hot or spicy food. [7] The lesions can extend to involve the palate. [7] Plasma cell cheilitis appears as well defined, infiltrated, dark red plaque with a superficial lacquer-like glazing. [5] Plasma cell cheilitis usually involves the lower lip. [3]