Mouth Ulcer: Or something else? Differential Diagnosis

Blood, blood-forming organs – immune system (D50-D90).

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Folic acid deficiency
  • Vitamin B12 deficiency

Skin and subcutaneous tissue (L00-L99)

  • Bullous erythema exsudativum multiforme (disc rose) – acute inflammation occurring in the upper corium (dermis), resulting in typical cocard-shaped lesions; a distinction is made between a minor and a major form.
  • Lichen ruber planus (nodular lichen).
  • Pemphigoid – group of blistering skin diseases.
  • Pemphigus – group of blistering skin diseases.

Infectious and parasitic diseases (A00-B99).

  • Angina Plaut-Vincent – relatively rare form of tonsillitis (inflammation of the tonsils) with pseudomembranous ulceration (ulceration) of the pharynx and tonsils (adenoids).
  • Bacteria (e.g., Borrelia vincentii, Fusobacterium nucleatum → necrotizing gingivostomatitis, rarely: Mycobacterium tuberculosis/tuberculosis).
  • Candidosis (synonyms: candidiasis, candidamycosis, candidamycosis, candidasis, candidosis; fungal infection), e.g. with Candida albicans.
  • Coxsackie virus infections – herpangina/preferably childhood-onset infectious disease; hand-foot-mouth disease (HFMK; hand-foot-mouth exanthema) [most common cause: Coxsackie A16 viruses].
  • Herpes simplex (herpes simplex virus type 1 – so-called “oral strain”).
  • Herpes zoster (human herpes virus type 3 (HHV-3).
  • HIV
  • Influenza virus (flu virus)
  • Infectious mononucleosis (Pfeiffer’s glandular fever) – common viral disease caused by Epstein-Barr virus (EBV); this affects lymph nodes, but can also affect the liver, spleen and heart.
  • Syphilis (lues; venereal disease) – Gumma / pl. gummae or Gummen: bulging elastic nodular elevation of the skin; tertiary stage of syphilis.

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Musculoskeletal system and connective tissue (M00-M99).

  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the corpus ciliary (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected

Neoplasms – tumor diseases (C00-D48).

Injuries, poisoning and other consequences of external causes (S00-T98).

  • Injuries of the mouth, unspecified (see also under “Other”).

Medication

  • Stomatitis medicamentosa (hypersensitivity reaction to drugs in the mouth).
    • Gold compounds
    • Cytostatics

Further

  • Alcohol abuse (alcohol dependence)
  • Tobacco abuse (tobacco dependence)
  • Toxic reactions, e.g.B. After exposure to heat, metal poisoning, chemical burns.
  • Physical irritation: Mechanical damage, e.g., due to pressure (denture ulcer), use of a hard toothbrush or