Oral manifestations of cutaneous

diseases
By
Amr Mohammad Ammar, MD
Lecturer of dermatology, venereology and andrology
Faculties of Medicine, Dental medicine and physical therapy, Al-Azhar
university, ECU , Cairo, Egypt
Amr Mohammad Ammar, MD
 Learning points
1-Oral mainfestions of cutaneous diseases
2-Infections
3- Non-infectious conditions

Amr Mohammad Ammar, MD

 Infections
Angular cheilitis.  Herpes simplex (cold
 Mucocutaneous candidiasis. sores).
 Herpes zoster (shingles).
Gingivitis and periodontitis.  Kawasaki disease.
Hairy leukoplakia.  Measles.
Hand foot and mouth disease.  Oral candidiasis (thrush).
Herpangina.  Scarlet fever (scarlatina).

Amr Mohammad Ammar, MD

 Non-infectious conditions
Actinic cheilitis Fissured tongue
Allergic contact cheilitis Cheilitis
Amalgam tattoo Chronic
ulcerative stomatitis
Angioedema Cicatricial pemphigoid
Aphthous ulcers Contact cheilitis in
Ascher syndrome musicians
Behcet disease Contact stomatitis
Dental sinus Cutaneous lupus
erythematosus
Burning mouth
Amr Mohammad Ammar, MD
Denture stomatitis Geographic tongue
Eczematous cheilitis (benign migratory glossitis)
Epulis Giant cell fibroma
Eosinophilic ulcer of the oral Gingival enlargement
mucosa Granulomatous cheilitis
Erosive lichen planus Hereditary gingival
Erythema multiforme fibromatosis
Exfoliative cheilitis Lichen planus
Fissured tongue Linear IgA bullous dermatosis
Fistulas and sinuses of the neck Malakoplakia
and face Mucocoele of the lip
Amr Mohammad Ammar, MD
Natal and neonatal teeth
Nicotine stomatitis
Oral allergy syndrome
Oral cancer
Oral dysaesthesia
Oral irritated fibroma
Oral leukoplakia
Oral lichenoid drug erupti
on
Oral lichen planus
Oral submucous fibrosis
Scurvy
Amr Mohammad Ammar, MD
Orofacial Crohn disease
Orofacial manifestations of inflamma
tory bowel disease
Orofacial granulomatosis
Paraneoplastic pemphigus
Pemphigus vulgaris
Pigmented contact cheilitis
Pyodermatitis-pyostomatitis
vegetans
Retrocuspid papilla
Riga-Fede disease
Solar cheilitis
Stevens Johnson syndrome / Toxic epidermal necrolysis (TEN)
Stomatitis
Teeth
Tongue conditions
Torus
Transient lingual papillitis
White sponge naevus

Amr Mohammad Ammar, MD

• Angular cheilitis is due to one or more of
the following factors:
A dribble of saliva causing
eczematous cheilitis a form of contact
irritant dermatitis
An overhang of upper lip resulting in
deep furrows (marionette lines).
Dry chapped lips.
Proliferation of bacteria (impetigo),
yeasts (thrush) or virus (cold sores).
Amr Mohammad Ammar, MD
 Chronic mucocutaneous candidiasis
• is a rare genetic condition
occurring in childhood that
affects
skin, nails and mucosal sites.
• It is characterized
by persistent and widespread
candida infection.

Amr Mohammad Ammar, MD

Gingivitis and periodontitis
Puffy, dusky red, swollen gums
tender and bleedy and foul breath
advanced periodontitis may present
with:
Swollen, tender, receding bright red or
purplish gums
New spaces between the teeth
Foul breath
Pus between the teeth and the gums
Loose teeth

Amr Mohammad Ammar, MD

 Hairy leukoplakia
• Irregular white patches on the side of
the tongue and occasionally elsewhere
on the tongue or in the mouth.
• It is a form of leukoplakia, which refers
to white patches on
the mucous membranes of the mouth
often arising in response
to chronic irritation.
• Hairy leukoplakia occurs primarily in HIV-
positive individuals.
Amr Mohammad Ammar, MD
 Hand foot and mouth disease (HFM)
• a common mild and short-
lasting viral infection most often
affecting young children.
• blisters on the hands, feet and in
the mouth.
• rarely affect adults.
• Hand foot and mouth disease is
also called
enteroviral vesicular stomatitis.
• May be caused by Coxsackievirus.
Amr Mohammad Ammar, MD
Herpangina
• is the name given to painful mouth and
throat ulcers due to a self-limited
viral infection and usually occurs in
childhood.

Amr Mohammad Ammar, MD

Herpes simplex
is a common viral infection that presents with localised blistering.
It affects most people on one or more occasions during their lives.
Herpes simplex is commonly referred to as cold sores
or fever blisters, as recurrences are often triggered by
a febrile illness, such as a cold.
Herpes simplex is caused by one of two types of herpes simplex
virus (HSV), members of the Herpes virales family of double
stranded DNA viruses.
Type 1 HSV is mainly associated with oral and facial infections
Type 2 HSV is mainly associated with genital and rectal infections
(anogenital herpes)
Amr Mohammad Ammar, MD
 Herpes zoster
• is a localised, blistering and painful rash caused by
reactivation of varicella-zoster virus (VZV).
• dermatomal distribution, that is the blisters are
confined to the cutaneous distribution of one or
two adjacent sensory nerves.
• This is usually unilateral, with a sharp cut-off at
the anterior and posterior midlines.
• is also called shingles.
• VZV is also called herpesvirus 3 and is a member of
the Herpesvirales order of double-
stranded DNA viruses.
Amr Mohammad Ammar, MD
 Kawasaki disease
• is an acute febrile illness
with inflammation of small- and medium-
sized blood vessels throughout the body, in
particular, the coronary arteries.
• previously known
as mucocutaneous lymph node syndrome.
• is usually self-limiting illness and resolves
spontaneously within 4-8 weeks.
• 20% of untreated
cases develop coronary artery damage and
approximately 2% of patients will die, most
commonly from a heart attack.
Amr Mohammad Ammar, MD
 Measles
• also known as English measles, rubeola
or morbilli, is a highly contagious
viral infection causing fever and a rash.

Amr Mohammad Ammar, MD

Oral candidiasis
• known as thrush
• Although candida is present in 50% of
the normal flora of healthy mouths, it
causes infection
• when increased numbers of yeast cells
invade the mucosa.

Amr Mohammad Ammar, MD

Scarlet fever
• is a bacterial illness that often presents with
a distinctive rash made up of tiny pinkish-red
spots that cover the whole body.
• It affects people who have recently had a
sore throat (strep throat) or impetigo caused
by certain strains of the group A beta
hemolytic streptococci bacteria.
• A toxin released by the streptococcal bacteria
causes the rash of scarlet fever.
• Scarlet fever has also been called scarlatina in
the past.
Amr Mohammad Ammar, MD
Actinic cheilitis
• presents as diffuse or patchy erythema
and thickening of the vermilion of the
lower lip.
• The common form of actinic cheilitis is
due to chronic sun exposure and is the
lip form of actinic keratosis.
• It is also called actinic cheilosis, solar
cheilitis, and sometimes, actinic cheilitis
with histological atypia.
• Actinic cheilitis also describes lip
involvement in actinic prurigo, a rare
form of photosensitivity.
Amr Mohammad Ammar, MD
• Allergic contact cheilitis is allergic
contact dermatitis affecting the lip(s).
• It is due to a type
IV hypersensitivity reaction following contact
with an allergen and usually presents as
an eczema-like inflammation of the outer lip
or vermilion margin.

Amr Mohammad Ammar, MD

Amalgam tattoo
• a blue, black or slate grey
coloured lesion found in the mouth.
most commonly occurs on the gum near
an amalgam filling but can occur
anywhere in the mouth.
• Amalgam is an alloy, or mixture of
metals, consisting of mercury, silver, tin
and copper.
• Amalgam fillings are sometimes known
as "silver fillings" due to their silver
coloured appearance.
Amr Mohammad Ammar, MD
 Angioedema
• is a skin reaction similar to urticaria.
• It is most often characterized by an abrupt
and short-lived swelling of the skin
and mucous membranes.
• All parts of the body may be affected but
swelling most often occurs around the eyes
and lips.
• In severe cases, the internal lining of the
upper respiratory tract and intestines may
also be affected.
Amr Mohammad Ammar, MD
Aphthous ulcer
• an ulcer that forms on the mucous membranes.
• They are also called aphthae, aphthosis,
aphthous stomatitis and canker sores.
• typically a recurrent round or oval sore or ulcer
inside the mouth on an area where the skin is not
tightly bound to the underlying bone, such as on
the inside of the lips and cheeks or underneath
the tongue.
• Aphthous ulcers can also affect the genitalia in
males and females.
Amr Mohammad Ammar, MD
Amr Mohammad Ammar, MD
Amr Mohammad Ammar, MD
Amr Mohammad Ammar, MD