Ulcers and membranous lesions of oral cavity and oropharynx is a common complaint encountered in E.N.T OPD. Proper knowledge of aetiopathology of these lesions is necessary to treat the underlying pathology. Objective was to study etiology, incidence, duration, episodes, number, sex predilection and histopathological presentation of these lesions.

Method: The prospective study was carried out in 100 patients presented in department of ENT & Dermatology from February 2015 to August 2016 with complaints of ulcers/membranous lesions of oral cavity/oropharynx. After taking the detailed history of patients complete examination of ear, nose and throat was done. Investigations like biopsy and histopathological examination, and swab test for culture and sensitivity were also carried out for chronic lesions.

Result: out of 100 patients 80 patients had ulcers and 20 patients had membranous lesions. 56 patients had acute ulcers and 44 had chronic ulcers. Overall sex incidence ratio was 1:1. 52 cases had solitary lesions whereas 48 cases had multiple lesions. 65 cases out of 100 had first episode of lesions while 35 cases reported as recurrence. Out of 44 cases of chronic ulcers histopathological studies reported 13 cases were that of squamous cell carcinoma and 13 cases were of leukoplakia, 4 were lichen planus and candidiais each and 3 were of pemphigus vulgaris.

Conclusion: ulcers and membranous lesions may be present due to various underlying pathologies. So proper diagnosis, through detailed history, clinical examination and investigations are warranted to find out cause and initiating treatment.

1. Miller MF, Ship Ii. A retrospective study of theprevalence and incidence of recurrent aphthous ulcers in professional population, 1958-1971. Oral Surg Oral Med Oral Pathol 43:532-7, 1977
2. Peretz B. Major recurrent aphthous stomatitis in an 11 year old girl:case report .J Clin Pediatr Dent 18 :309-12,1994
3. Rennie JS, Reade PC, Hay KD, Scully C. Recurrent aphthous stomatitis review, Br Dent J 159:361-7, 1985
4. Sircus W, Church R, Kelleher J. Recurrent aphthous ulceration of the mouth : a study of the natural history, aetiology, and treatment. Quart J Med 26:235-49, 1957
5. Lehner T. Pathology of recurrent oral ulceration and oral ulceration in Behcet’s syndrome: light, electron and fluroscence microscopy. J Pathol 97: 481-93, 1969
6. Ship II, Epidemiologic aspects of recurrent aphthous ulcers. J M Dent Assoc 73: 120-3, 1996
7. Denise M Laronde , T Greg Hislop, J. Mark Elwood, Miriam P. Rosin ; Oral Cancer :Just the Facts, Journal of Canadian Dental Association, Vol 74, April 2008.
8. Naik Balachandra Ramachandra , The Hierarchy of oral cancers in india. Research article. International Journal of Head and Neck surgery, September –December 2012;3(3):143-146
9. Saeedeh Eris, Ezzat Ollah Ghaemi , Abdolvahab Moradi , Azad Reaza Mansourian , Mohammad Reza Rabiei , Sepideh Bakhashande Nosrat, Ali Amirchaghmaghi and Ali Reza Ahmadi , 2007. Aphthous Ulcer and the Effective Factors on It`s Incidence among the Students of Golestan Medical Sciences University in the North of Iran.Journal of Biological Sciences, 7: 830-832.
10. Axell T, Henricsson V. The occurrence of recurrent aphthous ulcers in an adult Sweedish Population . Acta Odontol Scand 43:121-5, 1985(a)
11. Field EA, Brookes V, Tyldesley WR. Recurrent Aphthous ulcerations in Children: a review .Int J Pediatr Dent 2:1-10,1992
12. Bánóczy J. Follow-up studies in oral leukoplakia.J Maxillofac Surg. 1977 Feb;5(1):69–75
13. Scully C, MacFAdyen E, Campbell A. Oral manifestations incyclic neutropenia. Br. J Oral Surg 20:96-101, 1982
14. Alison J. Bruce , MD, Roy S. Rogers III. Acute Oral Ulcers. Dermatol Clin 21:1-15, 2003.
15. Rima Ahmad Sadafi, Prevalence of recurrent aphthous ulcers in Jordonian dental patients, BmC Oral Health 2009, 9:31
16. Scully C, Porter S. Recurrent aphthous stomatiti: current concepts of etiology, pathogenesis and management. J Oral Pathol Med 18:21-7, 1989
17. Helicobacter pylori in dental plaque and saliva. Kim N, Lim SH, Lee KH, You JY, Kim JM, Lee NR, Jung HC, Song IS, Kim CY Korean J Intern Med. 2000 Dec; 15(3):187-94.
18. Detection of Helicobacter pylori DNA in the oral cavity and gastroduodenal system of a Venezuelan population.Berroteran A, Perrone M, Correnti M, Cavazza ME, Tombazzi C, Goncalvez R, Lecuna V J Med Microbiol. 2002 Sep; 51(9):764-70
19. J. Dhanrajani l& O. Jonaide, Trismus: aetiology, diffrentyial diagnosis and treatment: Dent update 2002, 29,88-94)
20. Wray D, Ferguson MM< Mason DK, Hutcheon AW, Dagg JH, Recurrent aphthae,treatment with vitamin B12, folic acid and iron. Br Med J 2:490-3, 1975
21. Rees TD, Binnie WH. Recurrent aphthous stomatitis. Dermatol Clin. 1996;14:243–56
22. Salisbury PL, Jorizzo JL, Oral ulcers and erosions. Adv Dermatol 1993; 8-31;79
23. Hebert, A.A, Lopez, M.D.Oral lesions in pediatric patients. Adv Dermatol. 1997;12:169–193.
24. Olson JA, Feinberg I, Silverman S, Abrams D, Greenspan JS. Serum vitamin B 12, folate and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med OralPathol 54: 517-20, 1982
25. Porter SR, Scully C, Pederson A. Recurrent aphthous stomatitis. Crit. Rev Oral Biol Med 9:306-21,1998
26. Brice SL, Cook D ,Leahy M Huff JC, Weston WL. Examination of the Oral Mucosa And Peripheral Blood cells of Patients with Recurrent aphthous Ulceration for Human Herpes Virus DNA. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:193-8, 2000
27. Abdollahi M, Radfar M.,A review of drug induced oral reactions J Contemp Dent Pract 2003 February ; (4) 1:010-031,
28. Alan Tack & Roy S. Rogers III, Oral Drug Reactions, Dermatologic therapy , vol 15 , 2002, 236-250
29. Scheid P, Bohadana A, Martinet Y. Nicotine patches for aphthous ulcers due to Behcet's syndrome.N Engl J Med. 2000;343:1816–17
30. Marija Bokor Bratic and Nada Vuckovic, cigarette smoking as a risk factor associated with oral leukoplakia, Archive of Oncology, 2002, 67-70
31. Chattopadhyay A¹,Chatterjee S. Risk indicators for recurrent aphthous ulcers among adults in the US, Community Dent Oral Epidemiol. 2007 Apr;35(2):152-9
32. Ship II, Moris AL, Durocher RT, Burket L.W. Recurrent aphthous ulceration in a professional school student population . IV- Twelve months study of natural disease patterns. Oral Surg Oral Med OralPathol 14:30-9, 1961.
33. Miler MF, ship II. A retrospective study of the prevalence and incidence of recurrent aphthous ulcers in a professional population, 1958-1971. Oral Surg Oral Med Oral Pathol 43:532-7,1977
34. Ship II. Inheritance of aphthous ulcers of  the mouth. J Dent Res 44:837-44,1965
35. Miller MF, Garfunkel AA, Ram CA, Ship II. The inheritance of recurrent aphthous stomatitis. Observations on susceptibility. Oral Surg Oral Med Oral Pathol 49:409-12, 1980.
36. Ship II. Epidemiologic aspects of recurrent aphthous ulcerations. Oral Surg Oral Med Oral Pathol 33:400-6, 1972
37. Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS, Preston-Martin S, Bernstein L, Schoenberg JB, Stemhagen A, Fraumeni JF Jr. Smoking and drinking in relation to oral and pharyngeal cancer.Cancer Res. 1988;48(11):3282–7
38. Preeti Sharma,Susmita Saxena, Pooja Aggarwal: Trends in the epidemiology of oral squamous cell carcinoma in Western UP: An institutional study. Year : 2010 Volume : 21 Issue : 3 Page : 316-319
39. Prabhu SR, Daftary DK et al. Tuberculous ulcer of the tongue. J Oral Surg 1978; 36: 384–6

Dr Sandeep Chahande

Resident, Department of E.N.T., Gajra Raja Medical College, Gwalior, M.P. 474009, India

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