Other Causes of Oral Ulcers

Primary syphillis

  • Typically acquired by direct sexual contact with the infectious lesions of another person
  • Results in painless indurated ulcer at site of entry of bacterium Treponema pallidum
  • Most common site is genital, but oral and pharyngeal lesions can be the site of entry
  • Left undiagnosed and untreated can progress to secondary and tertiary syphilis

Mucosal leishmaniasis

  • Involvement of mucosal tissues of the nose, oral cavity, and pharynx by Leishmania spp.
  • Caused by Leishmania species in Africa and the Americas
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Behcet's disease

  • Inflammatory, multisystemic disorder
  • Recurrent oral ulcers are the most common feature
  • Other features include genital ulcers and uveitis
  • Can also involve visceral organs e.g. GI tract, pulmonary, MSK, cardiovascular and neurological systems
  • Commonest in Middle East and Asia

Coeliac disease or IBD

  • Recurrent aphthous ulcers frequently seen in patients with coeliac disease and IBD
  • Other symptoms include diarrhoea, weight loss

Reactive arthritis (Reiter's disease)

  • Arthritis which occurs in response to an infection in another part of the body, most commonly genitourinary infections (Chlamydia, Neisseria) or GI infections (Salmonella, Campylobacter)
  • Can cause painless oral ulcers

Drug reactions

  • Mouth ulcers can sometimes be caused by certain medications or treatments, such as NSAIDs, beta-blockers and sulfonamides

Skin disease

  • Lichen planus, pemphigus, or pemphigoid can present with oral ulcers