Ulcerative lesions of the mouth: an update for the general medical practitioner: [review]

Oral ulceration is a common complaint of patients attending out-patient clinics. Because of the diversity in causes of oral ulceration, patients presenting with oral mucosal disease can be challenging to diagnose and manage. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics; however, in most instances the ulcers do not result from gastrointestinal disease. The aim of the present article is to review aspects of the etiology, diagnosis and management of common ulcerative disorders of the oral mucosa. A search in the National Library of Medicine computerized bibliographic database MEDLINE was performed. Selection of publications, extraction of data, and validity assessment were then performed by the authors. Based upon the searched literature, it is concluded that there are several systemic disorders that can present with similar clinical signs and symptoms, and knowledge of each disease is necessary for the clinician to provide proper management.

A ulceração oral é uma queixa comum dos pacientes que são atendidos em ambulatórios. Com freqüência é difícil estabelecer um diagnóstico preciso e atingir o controle dos sinais e sintomas dos pacientes que apresentam ulceração oral. Os pacientes acometidos por ulceração oral são eventualmente encaminhados para os ambulatórios de gastroenterologia, entretanto, a maioria das úlceras não reflete doença gastrointestinal, e sim desordens sistêmicas que podem se apresentar com sinais e sintomas clínicos similares. O objetivo do presente artigo foi revisar aspectos da etiologia, diagnóstico e tratamento das desordens ulcerativas mais comuns da mucosa oral. Foi realizada uma busca no banco de dados MEDLINE da National Library of Medicine. A seleção dos artigos, coleta de dados e julgamento em termos da pertinência de inclusão foram realizadas pelos autores. Baseado na literatura pesquisada, foi concluído que existem várias doenças sistêmicas que podem apresentar sinais e sintomas clínicos semelhantes e o conhecimento de cada doença poderá guiar o clínico para uma intervenção apropriada.

Diagnostic criteria of Behcet's disease: problems and suggestions

There are no specific diagnostic laboratory tests for Behcet's disease. Diagnosis relies on proper history-taking and typical clinical manifestations. To provide more objectivity to the diagnosis, several diagnostic criteria have been introduced including one major set of guidelines by the International Study Group for Behcet's Disease (ISGBD) in 1990 which has made a significant contribution, although some disagreements exist in interpretation. Based on this criteria, recurrent oral ulceration is an obligatory manifestation for the diagnosis of Behcet's disease; however, some data indicates it is not a requirement for the diagnosis. In this article the author critically reviews different accepted diagnostic criteria or classifications of Behcet's disease and gives recommendations for a more thorough diagnosis.