Oral Ulcers – General Classification

In this Article, We will start with a basic Comparison between common types of  Oral Ulcers. The comparison will be  in the Etiology  , on the preceding lesion before the ulcers occurs and Recurrence.

But first, we must understand what is an Ulcer.

Definitions

Ulcers: Is the complete loss of epithelium. Always Heals with a scar
Erosion: is a superficial damage leading to partial loss of epithelium. No Scar Formation
In The Comparison and previous image, the difference between an ulcer and erosion is quite easy to understand.

Comparison

By Etiology

By Precursor Lesion

Primary Ulcers 

• Definition: an ulcer that  isn’t preceded by a vesiculobullous lesion 
• Examples:
  • Traumatic
  • Infective
  • Neoplastic
  • Systemic “GIT or blood disorders”
  • Aphthous ( The Most Common Oral Ulcers Read here about here) 
  • Behcet’s syndrome
  • Reiter’s Syndrome 

Secondary Ulcers

• Definition: an Ulcer that is preceded by a vesiculobullous lesion.
• Types: These vesicles may be sub-epithelial or intraepithelial (Acantholytic or Non- acantholytic)

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Sub Epithelial

• Bullous Pemphigoid
• Mucous Membrane Pemphigoid
• Erythema Multiforme
• Bullous Lichen Planus
• Epidermolysis Bullosa
• Drug Eruption

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Intraepithelial

• Non – Acantholytic: Death and rupture of groups of epithelial cells.
  • Examples:
    • Herpes Simplex
    • Herpes Zoster
    • Herpangina
    • Hand, foot and mouth disease
• Acantholytic: Destruction of intercellular attachments.
  • Eamples:
    • Pemphigus Vulgaris
    • Darier’s Disease

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By Recurrence