aphthous ulceration any ulcer lasting for longer than 2 weeks should be regarded with
suspicion and biopsied.
1005H
Fig. 15.3 Ulceration of the lower lip
produced by biting while still
anaesthetized from an inferior block.1006H
Fig. 15.4 Minor aphthous ulceration.
(By kind permission of Wolfe
Publishing.)15.2.3 Vesiculobullous lesions
Vesiculobullous lesions cause ulcers in the later stages of such conditions. Viral
causes have been mentioned above. Similarly, conditions such as epidermolysis
bullosa and erythema multiforme can produce oral ulceration in children. The major
vesiculobullous conditions such as pemphigus and pemphigoid are rare in young
patients.
Epidermolysis bullosa is a term that covers a number of syndromes, some of which
are incompatible with life. The skin is extremely fragile and mucosal involvement
may occur. The act of suckling may induce bullae formation in babies. In older
children effective oral hygiene may be difficult as even mild trauma can produce
painful lesions.
The oral lesions of erythema multiforme usually affect the lips and anterior oral
mucosa (1007HFig. 15.5). There is initial erythema followed by bullae formation and
ulceration. The pathogenesis of the condition is still unclear, however, precipitating
factors include drug therapy and infection. Treatment includes the use of steroids and
oral antiseptic and analgesic rinses to ease the pain.