Etiology • Oral changes found in approximately 5% of those with cuta-
neous reaction to drugs • Mucosal alterations may result from the following:
• Myelosuppression • Direct cytotoxic or cytostatic effect(s) on dividing epithelial
cells • Xerostomic effects • Alterations of oral microbial flora
Clinical Presentation • Painful, erythematous, erosive, or ulcerative lesions • Nonkeratinized locations often affected initially • Fixed form of drug-associated eruptions relatively uncommon
neous reaction to drugs • Mucosal alterations may result from the following:
• Myelosuppression • Direct cytotoxic or cytostatic effect(s) on dividing epithelial
cells • Xerostomic effects • Alterations of oral microbial flora
Clinical Presentation • Painful, erythematous, erosive, or ulcerative lesions • Nonkeratinized locations often affected initially • Fixed form of drug-associated eruptions relatively uncommon
intraorally • Pseudomembranous necrotic surface may be noted
Diagnosis • History • Clinical appearance
Differential Diagnosis • Chemical or thermal burn • Erosive lichen planus • Pemphigus vulgaris • Mucous membrane (cicatricial) pemphigoid • Erythema multiforme • Acute herpetic gingivostomatitis • Candidiasis
Treatment • Identification and withdrawal of offending drug • Symptomatic management including topical preparations
(see “Therapeutics” section)
• Systemic corticosteroids if mucosal reaction is not related to antineoplastic treatment
Prognosis • Generally excellent
Prognosis • Generally excellent