Syndrome

Metalic test with burning (Scaled) despite the normal saliva & the lining of the
mouth appears NORMAL.
Post menopausal women. Anterior 2/3 of the tongue
Burning mouth syndrome Diagnosis of exclusion --- Based on detailed history, clinical examination &
LABORATORY STUDIES
TTT -- Cognitive behavioral, Anxiolytics & anti-depressants.

Numerous spider like telangiectasia & anteriovenous fistula --- Liver & lung which is
Osler-Rendu-Webner fragile and rapture easily causing GIT bleeding & iron def. anemia.
may also be found on face, neck, chest, lips & Gingiva
syndrome
It's small dilated arteries near the surface of the skin or mucosa 1-3 MM
(Hereditary hemoragic Frequent nosebleeds.
telangiectasia)

macular Hemangioma that follows the distribution of the trigeminal nerve --- Port wine
stain.
Neurological problems include seizures & intellectual disabilities
Sturage-Webner syndrome - Glaucoma is also present
Encephalotrigeminal Intraoral --- hyper vascular changes in the ipsilateral of the gingiva which may
angiomatosis leads to gingival hyperplasia
TTT --- Anticonvulsant therapy is used to control both

Immune syndrome triggered by infectious or environmental agent in a genetically

predisposed individual. Males, 30-40 YO.
1- Small vessel vasculitis
Behcet's Syndrome 2- Recurrent oral (mostly minor aphtous in Soft palate and oropharynx)
3- Eye: conjunctivitis, uveitis and genital aphtous-type ulcers.
TTT --- Steroids and immunosuppressants

Vasculitis + Necrosis + Granulomas. Rare chronic immune disorder, unknown cause.

Lesions of respiratory tract, necrotizing glomerulonephritis, vasculitis of small
vessels.
Oral: Strawberry gingivitis, ulceration on any mucosal surface.
Wegener Granulomatosis Clinical presentation + microscopic findinsg of necrotizing and granulomatous
- Granulomatosis with vasculitis will lead the diagnose
polyangiitis Lab markers: cANCAs and pANCAs
TTT--- Corticosteroids and Cyclophosphamide (chemo drug)

Cutneous lesions of the external auditory canal, involvement of the ipsilateral

facial & auditory nerves, facial paraylsis, hearing deficits & vertigo.
It's severe form of post herpatic neuralgia (Shingles), for older females with
burning, throbbing, aching, itching or stabbing pain eggravated bu touch.
TTT -- carbamazepine, gabapentin & pregabalin
Ramsay Hunt Syndrome
 Syndrome
Severe, triggered by sulphonamides (Drug) extensive
vesicles-->Ulcers with pseudo membrane (painful).
Steven-Johnson Oral mainly non-keratinized mucosa, always present.
Syndrome Skin: Target Lesions.
Triad: Eye (Conjunctivitis), genital (balanitis, vulvovaginitis) and oral lesions
(Stomatitis). TTT: to remove the drug IMM. self limiting 2-6 W

combines iron deficiency anemia with glossitis, dysphagia due to esophageal webs, and
koilonychias(Spoon-shaped brittle nails).
Plummer-Vinson Premalignant (5-50% increase in oral and esophageal SCC).
Syndrome Systemic: Anemia Sx.
Oral: Burning sensation in tongue and oral mucosa, Angular cheilitis.

Multiple Odontogenic Keratocyst (OKC)

Multiple basal cell carcinoma
Nevoid Basal Cell Carcinoma Falix cerebri
Palmar/plantar pits. Epidermal cyst of the skin
Syndrome
Rib anomalies
Gorlin Goltz Syndrome
Spina bifida Mild ocular hypertelorism

Genetic Disorder
Endocrine abnormalities --
Tried
- Polyostotic fibrous dysplasia.
McCune Albright
- Premature puberty in females.
- Unilateral "Café-au-lait" spots
Hyperthyroidism, pituitary adenoma

Dental abnormalities.
MULTIPLE IMPACTED / SUPERNUMERARY TEETH
MULTIPLE JAW OSTEOMAS: "COTTON WOOL"
MULTIPLE ODONTOMAS
Gardner's Syndrome Multiple osteomas
Fibromas of the skin
Abnormalities of the retina.
Colorectal polyps (become adenocarcinoma by 5th decade of life)
it's condition of langerhans cell disease, Chronic Disseminating. bad prognosis
TRIAD:
Lytic bone,
Hand Schuller-Christian Exophthalmos,
Diabetes Insipidus. (bone, skin, visceral organs)

Acute Disseminating Bones, organs skin. Usually affect Infants

Letterer-Siwe Disease: FATAL, it's type of Langerhans cells disease
 Syndrome

Chronic systemic Autoimmune disorder

· Primary: alone. Secondary: associated w SLE, Rheumatoid arthritis
Dry mouth- XEROSTOMY, cause caries.
Dry eyes- KERATOCONJUNCTIVITIS SICCA
SJOGREN SYNDROME -
Difficult in swollen, alternate taste, oral mucosa red and tender, tongue
SICCA SYNDROME
fissured and atrophic.
XRAY: Sialography shows
Sialectasia w/ "Fruit-laden" or "branchless tree" pattern.
HISTO: Lymphocytic infiltration causing destruction in acinar cells

Cardiovascular and neurologic problems). Due to Vit. B1 Thiamin Dif

Beriberi syndrome

Gustatory sweating Patient refers

FREY'S SYNDROME Flushing and sweating on his/her face during eating.
AURICULOTEMPORAL When auriculotemporal nerve after Parotid gland removed, heals
SYNDROME innervating accidentally sweat glands of the face instead.
TRIAD:
MELKERSSON-ROSENTHAL · Cheilitis Granulomatosa
SYNDROME · Facial paralysis (unilateral)
· Fissured tongue
autosomal dominant disorder, ChCh. with
Multiple macules -- Send the pt to cheeck his intestine
Gastrointestinal polyps
Gastrointestinal polyps in small intestine Jejunum & Ileum which is
Peutz-Jeghers syndrom - painful with rectal bleeding and
Hereditary interstinal diarrhea and malignant trasformation --- Colorectal adenocarcinoma
polyposis Intraoral & preoral macule which is first to appear in lower lip, buccal
mucosa, gingiva & hard palate

MENS III - type 2B

*Medullary carcinoma of thyroid.
*Pheochromocytoma of adrenal medulla.
ORAL:
Multiple endocrine neoplasia *Asymptomatic soft nodule Lip, anterior tongue, buccal mucosa,
palate & gingiva.
sydrom
Mucocutanous numerous oral mucosal neuroma is the first sign to appear
MEN syndrom
--- important to early diagnosis.
If present --- endocrine examination is indicated
 Syndrome
due to Mutation in gene NF1, Autosomal dominant inherited
Oral:*Multiple neurofibroma.
*Enlargement of Fungiform papollae resulting in tongue enlargement.
Skin:
Van Recklinhouse Syndrom *Café-au-lauit Pigmentation. *Iris frecking (Lisch nodules).
*Auxillary freckling (Crowe sign).
Systemic:
*Hypertension.*Pheochromocytoma.*CNS tumors.*Mental deficiency.
*Seizures.
Inherited Dev. Disorder
Cl/F
Piere Robin Syndrom *Cleft palate
*Micrognathia-- Class II
*Glossoptosis --Posterior displacement of tongue

Malformation of skull & digits

*Craniosynostosis--Premature fusion of fibrous sutures by bone.
*Acrobrachycephaly-- tower skull, mid facial hypoplasia, relative
mandibular prognathism
Apert Syndrom - Acro- *Occular proptosis, hypertelorism, increase intracranial pressure.
cephalosyndactyly *Bifid uvula, cleft palate, severe crowding, open bite, anterior & posterior
cross bite,
shovel shaped incisors, delayed eruption.
* Syndactyly-- fusion of 2 or more digits

Skull:
*Craniosynostosis--Premature fusion of fibrous sutures by bone.
*Brachycephaly (Short head)
*Occular proptosis, hypertelorism, increase intra cranial pressure.
Intraoral:
*Midface hypoplasia, underdeveloped maxilla leads to Class III,
Crouzon Syndrom - bilateral posterior cross
Craniofacial bite, over crowding of teeth.
dysostosis * X-Ray of the skull show increased digital markings called Beaten-Metal
 Syndrome
Craniofacial:
Hypo plastic zygoma Narrow face *Depressed check *Ear defects
*Downward-slanting of eye
*Hypoplasia of nasopharynx & oropharynx.
Treacher Collins Syndrom - Oral:
Mandibulofacial Dysostosis *Mandibular hypoplasia.
Mid-face hypoplasia. Retorted chin. *Cleft palate
*Malocclusion
*Flattened aplastic condyle & cronoid process.

Craniofacial:
Hypertolerism Flat face*Hypoplastic maxilla
Rieger's syndrom - Protrude lower lip Broad flat nasal ridge
Craniofacial Intraoral:
dysostosis *Anodontia or hypodontia
Microdontia with conical crownEnamel hypoplasia *Malposition of teeth
Eye: *Glucoma.

Craniofacial:
*Face short,broad and flat,hypoplastic mid face
Ocular Hypertolerism Hypoplastic maxilla
Downward-slanting of eye Upward-slanting palpebral fissures.*Flat
nasal bridge.
Oral:
Macroglossia-- large fissured protruding tongueMouth breathing & open
bite with class III*Increase
Down syndrom - Trisomy 21 periodontal disease.
*Dental caries not greater than normal person.
Delayed eruption of teeth & malocclusion.Hypodontia & high arched
palate.*Relative mandibular
prognathism.
Systmic:
Mental & physical delayed Dev.Congenital heart diseases.

Due to congenital syphilis:

1- Interstital keratosis
2- Eight-nerve deafness
Hutchinson Tried 3- Hutchinson incisors & Mulbury molars.
Infants infected can display sign within 2 - 3 weeks of birth.