Zusammenfassung der Ressource
Oro-facial Granulomatous
Disorders
- Infectious
- Tuberculosis
- Types of infection
- 3) Secondary
- Reactivation usually with
reduced host defences
- Oral (rare)
- Ulcers or nodules on
tongue or hard palate
- single or multiple
- Painful or Painless
- Cervial LN & salivary gland swelling
- 1) Exposure to TB
- Primary
- Infection in lungs - formation of nodules
- Oral (rare)
- Tongue ulcers
- 95% asymptomatic
- 2) Bacteria latent
- Diagnosis
- Biopsy
- Ziehl Niesson staining
- Granulomas of TB with
caseating necrosis
- Mycobacterium tuberculosis
- Droplet inhalation
transmission
- Tertiary Syphillis
- Treponema pallidum
- Sexually transmitted disease
- Presentation
- Rare - treated before this stage
- Gummas = granulomatous lesions
- Hard palate = common
- Can perforate
- can involve skin, CNS, liver
- Earlier stages
- Primary
- Presentation
- Chancre
- = painless, indurated ulcer
- At site of innoculation
- Most comon = genitals
- Can be on tongue, lip, palate
- Resolves itself in 3-6wks
- Highly infectious
- Bilateral, painless
lymphadenopathy
- Secondary
- Presentation
- Most common = rash
- Red/pink macules
- Not itchy
- Arms, flanks, palms & soles
- Symmetrical
- Can last wks-months
- Other stages
- Latent
- Congenital
- From pregnant
mother to foetus
- Effects
- Still-birth, neonatal death
- Hutchison's triad = notched incisors, deafness, ocular keratitis
- Treatment = antibiotics
- Diagnosis
- DIF/PCR/microscopy
- Serological tests
- Actinomycosis
- Rare, chronic
- Actinomyces spp.
- Forms
- Cervicofacial = most common
- Slow, progressive, indurated mass
- Multiple abscesses & sinus tracts
- Yellow, purulent discharge
- Thoracic
- Abdominal
- Diagnosis
- Histopathology
- Cultures
- Parasites
- Non-infectious
- Idiopathic OFG
- = restricted to oral cavity with no
known granulomatous disease
- Crohn's disease
- Clinical features
- Oral
- Angular cheilitis
- Cobblestone mucosa
- Aphthous-like oral ulcers
- Stomatitis
- Peripheral arthritis, erythema nodosum,
pyogenic gangrenosum
- Uveitis, Episcleritis
- Diarrohea, weight loss,
anaemia, abdominal pain
- = Inflammatory bowel disease
- Affects
- Proximal colon
- Terminal ileum
- Melkerson's Rosenthal Syndrome
- Clinical presentation
- Fissured tongue
- Facial paralysis
- Facial swelling (lips)
- Most common = lower lip
- Rare for all to occur
at the same time
- Management
- Elimination of diet
- Topical Steroids
- Weekly local injections of
triamcinolone acetonide
- Aetiology
- Hypersensitivity
- Foods
- Dental materials
- Infections
- Mycobacteria
- Cheilitis granulomatosa
- Young adults
- Clinical presentation
- Recurrent, painless swelling of lips
- Swelling becomes firmer
with each recurrence
- More common than complete triad
- Wegener's granulomatosa
- Clinical presentation
- Systemic Vasculitis
- Necrotic glomerulonephritis
- Granulomatous lesions in respiratory tract
- Strawberry gingivitis =
Hyperplastic granular gingivitis
- Hearing loss
- Lung symptoms (cough, haemoptysis
- Investigations
- Chest X-ray
- Biopsy
- Sarcoidosis
- Clinical presentation
- Pulmonary issues
- Skin
- Erythema nodosum
- Liver
- Oro-facial
- Bilateral parotid swelling
- Soft tissue swelling
- Investigations
- Chest X-ray
- Bat wing
- Biopsy
- High blood ACE levels
- Young-middle aged women
- Treatment
- Corticosteroids
- = multisystem granulomatous
disorder with unknown cause
- Foreign body reaction