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O-6 Clinical Overview Ulcerative Conditions Disease Clinical Features Cause Signifcance Reactive lesions Painful ulcer lined by yellow Trauma, chemical substances, heat, Self-limited; heals in days to fbrin membrane; prognosis radiation weeks; factitial injuries follow often evident from seem unpredictable course ance when combined with historical past; frequent; traumatic factitial accidents are diagnos tic problem Syphilis Primary (chancre): single, Spirochete: Treponema Primary and secondary varieties indurated, nonpainful ulcer pallidum are extremely infectious; mimics at website of spirochete entry; different illnesses clinically; if spontaneously heals in untreated, secondary type four-6 weeks develops in 2-10 weeks; a Secondary: maculopapular minority of sufferers develop rash on skin; oral ulcers tertiary lesions; latency peri lined by membrane ods, in which there is no (mucous patches) clinically apparent disease Tertiary: gummas, cardiovas seen between primary and cular and central nervous secondary phases and system lesions between secondary and ter Congenital: dental abnormali tiary levels; untreated, 30% ties (mulberry molars, progress to tertiary stage notched incisors), deafness, interstitial keratitis (Hutchinson�s triad) Gonorrhea Typically, genital lesions, with Neisseria gonorrhoeae May be confused with many rare oral manifestations, oral ulcerative ailments painful erythema or ulcers, or each Tuberculosis Indurated, chronic ulcer that Mycobacterium tuberculosis Lesions are infectious; oral could be painful�on any lesions almost all the time a mucosal floor results of lung lesions; differ ential prognosis includes oral cancer and continual trau matic ulcer Leprosy Skin illness, with uncommon oral Mycobacterium leprae Rare in United States but rela nodules/ulcers tively widespread in Southeast Asia, India, South America Actinomycosis Typically seen in mandible, Actinomyces israelii Infection follows entry through with draining skin sinus; a surgical web site, periodontal wooden-hard nodule with disease, or open root canal yellow, �sulfur� granules Continued Clinical Overview O-7 � Figure 7 Chronic traumatic ulcer. 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