Mouth ulcers - Stomatitis

Japanese: 口内炎 - こうないえん（英語表記）Stomatitis

What is the disease?

Stomatitis is not a term that refers to a single disease (illness), but a general term for inflammation that occurs in the mucous membrane inside the mouth, and refers to inflammation that occurs over a relatively wide area or in a scattered manner. If the stomatitis is localized to a specific area, Glossitis ( Completed ) , Gingivitis ( Death ) , Angular cheilitis ( Public transport ) When the cause is clear, such as stomatitis caused by Candida (fungus) or herpes virus infection, it is called candidal stomatitis or herpes stomatitis.

Also," Oral mucositis ( International festival ) " refers to inflammation of the mucous membrane inside the mouth that occurs due to treatments such as anticancer drugs and radiation exposure, and is distinct from the commonly used term "stomatitis."

What is the cause?

There are various causes, including bacteria, viruses, allergies (to dental metals, fruits, and other foods), and medications, but in many cases the cause cannot be identified, and some are caused by blood diseases such as leukemia and anemia. Triggers include fatigue, decreased physical strength, immune disorders, vitamin deficiency, mental stress, genetic factors, and poor oral hygiene.

How symptoms manifest

A wide area of the mucous membrane in the mouth may become red and inflamed, and small round ulcers called blisters or aphthae or large ulcers may appear. Pseudomembrane ( Exciting ) The white Mossy ( Kokeshojo ) A film may form on the surface of the skin.

Initially, symptoms include a rough mouth and stinging pain, but as the condition progresses, pain on contact becomes more severe and symptoms such as difficulty eating, swallowing, and speaking appear.

Angular cheilitis is a disease that causes cuts and sores at the corners of the mouth, and is caused by Candida fungus or a deficiency of B vitamins.

Testing and diagnosis

It is relatively easy to diagnose stomatitis caused by local factors, but those caused by systemic diseases may require blood tests and immunological tests.

If symptoms include cracks at the corners of the mouth or redness and stinging of the mucous membrane, culture tests or microscopic examinations will be performed to check for the presence of Candida.

Treatment methods

For localized treatment, mouthwashes and ointments are used. When the cause is known, such as a viral or fungal infection, medications that are effective against that infection are used. For systemic illnesses, appropriate medications are taken, but even in these cases, it is important to keep the mouth clean.

What to do if you notice an illness

If the symptoms are mild, you can wait and see, but if they persist, we recommend that you see a specialist. If stomatitis develops throughout your mouth, you may lose strength due to not being able to eat, which can lead to other illnesses, so please see an oral medicine, oral surgery, internal medicine, dermatology, or pediatrics specialist as soon as possible.

Yoshimasa Kitagawa and Yutaka Yamazaki

Mouth ulcers
Stomatitis
(throat illness)

What is the disease?

Stomatitis is a general term for a variety of diseases in which inflammatory lesions occur in the mucous membrane of the oral cavity.

What is the cause?

Chemical damage from chemical substances, physical damage from contact with dentures, general bacteria, tuberculosis ( Results ) , syphilis ( Vidox ) , fungi ( Shinkin ) The causes include mold, viral infection, iron and vitamin deficiency. Other causes include skin diseases, Collagen disease ( Public health center ) Some cases are accompanied by systemic diseases such as the above. The cause is often unknown.

How symptoms manifest

Pain and discomfort appear in the mouth. It is not uncommon for people to accidentally notice something abnormal in their mouth when looking in the mirror.

Testing and diagnosis

The characteristics of the mucous membrane are carefully observed and a diagnosis is made based on the cause and progression of the symptoms.

If the mucous membrane of the mouth is red overall, it may be due to catarrhal stomatitis, which is caused by bacterial infection.

The mucous membrane may show round, whitish lesions measuring a few millimeters in size with red surroundings, which are called aphthous lesions. These lesions are seen in aphthous stomatitis and Behçet's disease.

In lesions where the mucosa is deeply excavated, Ulcerative ( Monster ) This may be due to stomatitis. It may also be due to cavities or dentures, but a tissue examination is required to distinguish it from tuberculosis, syphilis, cancer, etc.

If white, dot-like lesions are seen, stomatitis caused by Candida, a type of fungus, is suspected.

Stomatitis caused by a viral infection is often caused by the herpes simplex virus. It is characterized by the appearance of small blister-like lesions on the lips and mucous membranes inside the mouth, which tend to recur repeatedly. Hand, foot and mouth disease ( Hand and foot disease ) , measles ( Machine ) However, lesions found inside the mouth may provide clues to the diagnosis.

In addition, Pemphigus ( Temporomandibular joint ) , Pemphigus pemphigus, Lichen planus ( Henpeitaisen ) Skin diseases such as those mentioned above can also appear inside the mouth, and lesions can be found in the oral mucosa in association with collagen diseases such as systemic lupus erythematosus, so we also thoroughly examine the patient's entire body to see if there are any abnormalities.

Treatment methods

We keep the oral cavity clean using mouthwash, and treat each cause.

What to do if you notice an illness

It may be necessary to differentiate it from a serious illness, so be sure to see a doctor. The department you should visit will vary depending on the illness, but it is best to first consult an otolaryngologist.

Kazunari Ichinomiya

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　口内炎とは、ひとつの病気（疾患）を指す言葉ではなく、口のなかの粘膜に生じる炎症を総称したもので、炎症が比較的広範囲あるいは散在性に生じたものをいいます。口内炎が特定の場所に限局している場合は、舌炎(ぜつえん)、歯肉炎(しにくえん)、口角炎(こうかくえん)のように呼ぶのが一般的です。カンジダ（真菌）やヘルペスウイルス感染による口内炎など原因が明らかな場合は、カンジダ性口内炎、ヘルペス性口内炎のように呼ばれます。

　また、「口腔粘膜炎(こうくうねんまくえん)」は、抗がん薬、放射線照射などの治療に関係して起きる口のなかの粘膜の炎症を指し、一般的に使われる「口内炎」とは区別されます。

原因は何か

　原因は細菌、ウイルス、アレルギー（歯科金属やフルーツなどの食物）、薬剤などさまざまですが、原因が特定できないものも多く、白血病、貧血など血液の病気で生じるものもあります。誘因として疲労、体力の低下、免疫異常、ビタミン欠乏、精神的ストレス、遺伝的要因、口腔清掃不良などがあげられます。

症状の現れ方

　口内の広い範囲の粘膜が赤くただれたり、水ぶくれやアフタと呼ばれる小さな丸い潰瘍や大きな潰瘍ができたりします。時に、偽膜(ぎまく)という白い苔状(こけじょう)の膜ができることがあります。

　自覚症状としては、はじめは口が荒れたり、しみて痛い程度ですが、進行すると接触痛が強くなり、食事がとれない、飲み込みにくい、しゃべりにくいなどの症状が出ます。

　口角炎は口角部が切れたりただれたりする疾患で、カンジダ菌やビタミンB群の欠乏が原因で起こります。

検査と診断

　局所的な原因で起こる口内炎の診断は比較的容易ですが、全身的な病気で起こるものでは血液検査、免疫学的検査などが必要になることがあります。

　口角が切れたり粘膜が赤くなりしみるなどの症状がある時には、カンジダ菌の存在を調べるための培養検査や顕微鏡検査を行います。

治療の方法

　局所的には、うがい薬や軟膏が用いられます。ウイルスや真菌感染のように原因がわかっている場合には、それぞれに効く薬を使用します。全身的な病気によるものでは、それぞれに応じた薬を服用しますが、その場合でも口のなかを清潔にすることが大切です。

病気に気づいたらどうする

　症状が軽い場合は、様子をみていてもよいのですが、長引くようなら専門医を受診することをすすめます。口全体に口内炎ができてしまったら、食事がとれないために体力を消耗して余病を起こすことがあるので、早めに口腔内科、口腔外科、内科、皮膚科、小児科などを受診してください。

北川　善政, 山崎　裕

口内炎
こうないえん
Stomatitis
(のどの病気)

どんな病気か

　口内炎とは、口腔の粘膜に炎症性の病変が生じた疾患の総称で、これにはさまざまなものが含まれています。

原因は何か

　化学物質による化学的傷害、義歯などの接触による物理的傷害、一般細菌、結核(けっかく)、梅毒(ばいどく)、真菌(しんきん)（カビ）やウイルスの感染、鉄、ビタミンの欠乏などが原因としてあげられます。そのほか、皮膚疾患、膠原病(こうげんびょう)など全身疾患に伴うものもあります。原因不明のことも少なくありません。