Ulceration

Oral ulcerative lesions are common and may be manifestations of local or systemic disease of immunogenic, infectious, malignant, or traumatic origin. The patient's history is important because it indicates whether the lesions are acute or chronic, single or multiple, and primary or recurrent.

Oral pain is frequently related to ulceration of the lips or tongue. Cancer is not the most common cause of oral cavity ulceration, but it must always be considered. When a patient complains of ulceration, ask the following questions:

Have you had a lesion like this before?'' ' 'Are there multiple lesions?'' How long have the lesions been present?''

''Are there lesions anywhere else on the body, such as in the vagina? In the urethra? In the anus?'' ''Are the lesions painful?'' ''Do you smoke?'' If so, ' 'How much?'' ''Do you drink alcohol?'' ''Do you have a history of venereal disease?''

The examiner should ask about a patient's sexual habits. These questions were discussed in Chapter 1, The Interviewer's Questions. Smoking and drinking alcohol predispose an individual to precancerous lesions of the mouth, such as leukoplakia and erythroplakia.

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