Etiology • Local tumoricidal doses of ionizing radiation • Destruction of germinative layers of oral mucosal epithelium
within radiation portal • May be enhanced by intraoral gram-negative bacteria
Clinical Presentation • Mucosal erythema, atrophy, necrosis, ulceration, and
pseudomembrane formation • Generalized pain and dysfunction • Ultimately, broadly based, contiguous ulcers form. • Usually begins within 7 to 10 days following the start of
treatment • Exacerbated by radiation-induced xerostomia or chemotherapy/
within radiation portal • May be enhanced by intraoral gram-negative bacteria
Clinical Presentation • Mucosal erythema, atrophy, necrosis, ulceration, and
pseudomembrane formation • Generalized pain and dysfunction • Ultimately, broadly based, contiguous ulcers form. • Usually begins within 7 to 10 days following the start of
treatment • Exacerbated by radiation-induced xerostomia or chemotherapy/
cytoreductive therapy
Diagnosis • History and appearance
Differential Diagnosis • Erythema multiforme • Chemotherapy-induced stomatotoxicity • Acute erythematous candidiasis • Neutropenic ulcer
Treatment • Systemic antiviral, antibacterial therapy • Topical agents
• Water-soluble polymer films • Antimicrobials • Saline rinses • Antifungal agents
• Granulocyte-macrophage colony-stimulating factor • Local and hygiene measures
Prognosis • Good • Improves slowly subsequent to treatment