Oral Medicine. Dr. Qianming Ian CHEN

Size: px
Start display at page:

Download "Oral Medicine. Dr. Qianming Ian CHEN"

Transcription

1 Oral Medicine Dr. Qianming Ian CHEN

2 ORAL MEDICINE Oral medicine is the specialty of dentistry that is concerned with the oral health care of medically compromised patients and with the diagnosis and nonsurgical management of medically related disorders or conditions affecting the oral and maxillofacial region. Oral medicine specialists are concerned with the nonsurgical medical aspects of dentistry. These specialists are involved in the primary diagnosis and treatment of oral diseases that do not respond to conventional dental or maxillofacial surgical procedures.

3 ORAL MEDICINE The Third World Workshop on Oral Medicine (Chicago, 1998) was charged with updating and summarizing the state of the field in four major areas: (1) Diseases of the oral mucosa (2) Infectious diseases of the orofacial region (3) Orofacial pain (4) Salivary gland and chemosensory disorders

4

5 DESCRIPTIVE TERMINOLOGY OF ORAL LESIONS

6 ORAL PAPULE small, solid, elevated lesion < 1 cm with about equal diameter and depth. Small Hill

7 ORAL NODULES Papules that grow become nodules. Solid tissue mass. > than 1 cm size. Inflammatory type. Neoplastic type. Nodules that grow become tumors. Small Mountain

8 ORAL MACULE Flat, well-circumscribed, non palpable, non-elevated lesion. Usually < 1 cm. Different color from surrounding skin. Present as black, purple, blue, brown, red, yellow and white lesions. Color Change

9 ORAL PLAQUE Solid raised lesions Usually > 1 cm Large papules

10 VESICLE & BULLA Elevated listerlike lesions containing clear fluid < than 1 cm: Vesicle > 1 cm: bulla Serum or Lymph Thin epi cover INTRA-EPIDERMAL or SUB-EPIDERMAL

11 PUSTULE A fluid filled sack that contains cloudy and or purulent material. Infection related. Painful Usually elevated.

12 ULCERS, EROSIONS, FISSURES o o o A defect in the epithelium: Ulcers Moist red lesions: Erosions A. Follows blister. B. Follows pustule. C. Epidermis lost: Linelike cut: Fissures

13 ORAL DISEASES PRESENT IN LIMITED WAYS A. Blister Vesicle Bulla B. Erosion Ulcer C. Papule Nodule Tumor

14

15 Infectious Diseases

16 Infections Viral Fungal Bacterial

17 Viral Infections Herpes Simplex Primary Herpetic Gingivostomatitis Secondary Herpetic Infections Herpes Zoster (Varicella) Herpangina Hand, Foot, and Mouth Disease

18 Herpes Simplex ETIOLOGY: HSV-1 and or HSV-2. AGE: HSV ; HSV-2 sexual maturity

19 Herpes Simplex Herpes simplex 1 (HSV-1) Most primary infections are silent. The incubation period: 5 7 days or 2 to 12 Usually associated with oro-facial lesions. However, in immunocompromised individuals the virus may disseminate.

20 Herpes Simplex Primary Herpetic Gingivostomatitis Prodromal symptoms: flulike A cluster of Vesicles Multiple shallow ulcers Both the keratinized and gland-bearing intra-oral surfaces Ulcerative gingivitis Systemic symptoms of fever, lymphadenopathy, myalgia.

21 Herpes Simplex Secondary Herpetic Infections The common coldsore or fever blister Precipitated by fever, menstruation, ultraviolet light, emontional strees A cluster of Vesicles Prodromal symptoms: tingling or burning lip lesions

22

23

24 Fungal Infections Candidiasis Systemic Mycoses Aspergillosis Histoplasmosis Cryptococcosis Mucormycosis Coccidioidomycosis Paracoccidioidomycosis Blastomycosis

25 Candidiasis Infection of the skin or mucous membrane with any species of Candida, but chiefly Candida albicans; Usually localized in the skin, nails, mouth, vagina, vulva, bronchi, or lungs, but may invade the bloodstream; Occurs commonly as a secondary infection associated with immune system compromise. Newborn infants may have contracted the organism during passage through the birth canal.

26 Candidiasis Caused by yeast-like fungus Common inhabitant in oral cavity Also known as moniliasis or thrush

27 Candidiasis Classification of Basic Types of Oral Candidiasis Acute Pseudomembraneous ("thrush") Atrophic ("erythematous") Chronic Hyperplastic ("candidal leukoplakia")

28 Candidiasis Acute Pseudomembraneous Candidiasis (Thrush) A clinical form of C. albicans infection that consists of creamy, loose patches of desquamative epithelium containing numerous matted mycelia over an erythematous mucosa that is easily removed; Common in patients with more severe predisposing factors.

29 Candidiasis Atrophic (Erythematous) Candidiasis A clinical form of C. albicans infection in which the mucosa is thinned, smooth, and bright red with symptoms of burning and increased sensitivity; commonly found on the palate under a denture but also on the tongue and other mucosal surfaces.

30 Candidiasis Chronic Hyperplastic Candidiasis A clinical form of C. albicans infection consisting of white plaques or papules against an erythematous background containing hyphae in the parakeratin layer of the thickened epithelium.

31

32 Common Oral Lesions Associated with HIV Infection

33 Common Oral Lesions in Patients with AIDS Candidiasis Intraoral Esophageal "Hairy" leukoplakia Diffuse herpes simplex gingivostomatitis Diffuse varicella-zoster lesions Kaposi sarcoma Non-Hodgkin lymphoma HIV gingivitis / periodontitis Acute nonspecific ulcers

34 HIV CANDIDIASIS Considered predictive of HIV infection and onset of AIDS High dose antifungal needed.

35 Kaposi s Sarcoma(KS) Oral KS has a variety of clinical presentations Initially oral KS may appear as a small patch Color may range from bluish-purple to a deep red or even black With time, the lesion may become exophytic and nodular and darken in color

36 Kaposi s Sarcoma(KS) KS may be seen anywhere in the oral cavity, including the gingiva Palate appears to be the most common location The larger lesions may be ulcerated and uncomfortable

37 Hairy Leukoplakia(HL) Clinical Description Oral HL is a lesion which is seen in the HIV-infected individual HL may be one of the first signs of HIV infection and a significant clinical marker un terms of predicting the development of AIDS HL appears as an irregular shaped white plaque which cannot be rubbed off.

38 Hairy Leukoplakia(HL) The plaque may appear smooth, corrugated or shaggy(hairy) Usually seen on the lateral borders of the tongue but may occasionally involve the dorsal or ventral tongue, or buccal and labial mucosa

39 Hairy Leukoplakia(HL) Clinical Description HL may vary in size, small localized lesions are just as prognostic for the development of AIDS as large profuse ones HL is typically asymptomatic and may occur unilaterally or bilaterally Candida is often found to exist concomitantly with HL

40 HIV COURSE: adapted from: Mandel (Ed.) (1997). Atlas of Infectious Disease, Paramount, Hong Kong.

41

42 Immune Related Mucocutaneous Diseases and Dermatological Disorders

43 Allergic Reactions varied and nonspecific in appearance may be asymptomatic or painful 2 types stomatitis medicamentosa contact stomatitis agents commonly implicated dental metals flavoring agents

44 Contact Stomatitis Patients who react sensitively shortly after contact with an allergen. Erythema and edema Sensitivity to various stimuli May take many forms including erythematous, ulcerative/erosive, and leukoplakic Confirmation by patch test

45 Stomatitis Medicamentosa An allergic reaction of the oral mucosa to the systemic administration of a medication. Oral Mucosal Allergic Reaction Patterns Erythema multiforme Anaphylactic stomatitis Intraoral fixed drug eruptions Lichenoid drug reactions Lupus erythematosus-like eruptions Pempigus-like drug reactions Nonspecific vesiculo-ulcerative lesions

46 Stomatitis Medicamentosa Anaphylactic stomatitis An allergic reaction of the oral mucosa to the systemic administration of a medication.

47

48 Immune-Mediated Diseases

49 Immune-Mediated Diseases PemphigusVulgaris Paraneoplastic Pemphigus Cicatricial Pemphigoid Linear IgA Disease Angina Bullosa Hemorrhagica Epidermolysis Bullosa Acquisita Bullous Pemphigoid Erythema Multiforme Stevens-Johnson Syndrome Toxic Epidermal Necrolysis

50 Immune-Mediated Diseases Erythema Migrans Lichen Planus Graft-Versus-Host Disease Psoriasis Lupus Erythematosus Systemic Sclerosis CREST Syndrome

51 Pemphigus Vulgaris Autoimmune disease; acantholysis condition, the lesions are intraepithelial, IgG in epithelium. Very serious, potentially fatal skin disease. FEMALES, peoples of the Mediterranean Region (Jewish, Italian peoples). Clinical: Blisters rare, usually broken as erosion. Positive Nikolsky. B-PENS TX: Biospy and Oral Medicine and Dermatology treat (Steroids).

52 Pemphigus Vulgaris

53 Cicatricial Pemphigoid (Benign Mucous Membrane Pemphigoid, Mucous Membrane Pemphigoid) It is also referred to as cicatricial pemphigoid, since scarring can result during the healing process. Positive Nikolsky, C3 and IgG target cell junctions. FEMALES more common, blisters seen. TX: Biopsy and steroids.

54 Cicatricial Pemphigoid

55 Erythemia Multiforme Skin and oral tissues. Skin lesions have a characteristic "bull's-eye" or target appearance on the hand. Oral clinical characteristics of this condition include crusting and ulceration of the lips ulceration and erythema to varying degrees on the mucosal tissues involved.

56 Erythemia Multiforme Bulls Eye Lesions

57 Erythemia Multiforme ERYTHEMIA MULTIFORME

58 THANK YOU!

LESIONS OF THE ORAL CAVITY ORAL CAVITY. Oral Cavity Subsites 4/10/2013 LIPS TEETH GINGIVA ORAL MUCOUS MEMBRANES PALATE TONGUE ORAL LYMPHOID TISSUES

LESIONS OF THE ORAL CAVITY ORAL CAVITY. Oral Cavity Subsites 4/10/2013 LIPS TEETH GINGIVA ORAL MUCOUS MEMBRANES PALATE TONGUE ORAL LYMPHOID TISSUES LESIONS OF THE ORAL CAVITY David I. Kutler, MD, FACS Associate Professor Division of Head and Neck Surgery Department of Otolaryngology HNS Weill Cornell Medical Center ORAL CAVITY LIPS TEETH GINGIVA ORAL

More information

Oral Health & HIV. Professor Sudeshni Naidoo Department of Community Dentistry University of the Western Cape

Oral Health & HIV. Professor Sudeshni Naidoo Department of Community Dentistry University of the Western Cape Oral Health & HIV Professor Sudeshni Naidoo Department of Community Dentistry University of the Western Cape Importance & relevance of Oral HIV Lesions >70% of HIV+ve patients present with oral manifestations

More information

Autoimmune Diseases with Oral Manifestations

Autoimmune Diseases with Oral Manifestations Autoimmune Diseases with Oral Manifestations Martin S. Greenberg DDS, FDS RCSEd Professor Emeritus Department of Oral Medicine University of Pennsylvania Disclosure Statement I have no actual or potential

More information

Index. Dent Clin N Am 49 (2005) Note: Page numbers of article titles are in boldface type.

Index. Dent Clin N Am 49 (2005) Note: Page numbers of article titles are in boldface type. Dent Clin N Am 49 (2005) 273 278 Index Note: Page numbers of article titles are in boldface type. A Acanthosis nigricans, familial, 251 Amalgam tattoo, 197 198 Amphotericin B, 62 Ankyloglossia, 11 Anti-inflammatory

More information

Medical History. Oral Medicine and General Medicine

Medical History. Oral Medicine and General Medicine Medical History Oral Medicine and General Medicine Gingivitis herpetica acuta NECROTIZÁLÓ SIALOMETAPLASIA SOOR Medical History The life expectancy has recently increased and increasing By dental prevention

More information

VIRUS. Viral infection causing, or associated with diseases of the oral mucosa : Herpes Simpleks 1 & 2

VIRUS. Viral infection causing, or associated with diseases of the oral mucosa : Herpes Simpleks 1 & 2 VIRUS Viral infection causing, or associated with diseases of the oral mucosa : VIRUS Herpes Simpleks 1 & 2 Varicella - Zoster Coxsakie A PENYAKIT Primary Gingivostomatitis Herpetica Herpes Labialis Recurrent

More information

That. Name QUIZ. 60 SEPTEMBER 2017 // dentaltown.com

That. Name QUIZ. 60 SEPTEMBER 2017 // dentaltown.com QUIZ Name That General dentists are first in the line of practitioners that patients see for an oral lesion evaluation; therefore, a sound understanding of oral mucosal diseases and their clinical presentation

More information

Lesions & Lifestyles

Lesions & Lifestyles Lesions & Lifestyles attended a 3 hour Continuing Education Seminar on Oral Pathology presented by Nancy Dewhirst, RDH,BS on (date) at (location):. Course material is directly related patient care. Notes:

More information

Contents. 3 Diagnostic Tests and Studies Introduction Examination... 27

Contents. 3 Diagnostic Tests and Studies Introduction Examination... 27 Contents 1 Normal Anatomy... 1 1.1 Introduction... 1 1.2 Surface Landmarks... 1 1.3 Oral Mucosa... 3 1.4 Tongue... 5 1.5 Floor of Mouth... 6 1.6 Palate... 6 1.7 Dentition... 7 1.8 Temporomandibular Joint...

More information

Classification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease:

Classification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease: Classification: 1. Infective: 2. Traumatic: 3. Idiopathic: Recurrent Aphthous Stomatitis (RAS) 4. Associated with systemic disease: Hematological GIT Behcet s HIV 5. Associated with dermatological diseases:

More information

REF: Chap 1 (Pemphigus vulgaris/etiology and

REF: Chap 1 (Pemphigus vulgaris/etiology and Chapter 1: Vesiculobullous Diseases Test Bank MULTIPLE CHOICE 1. Intercellular deposits of IgG are consistently found in oral epithelium in which of the following? a. Cicatricial pemphigoid b. Lichen planus

More information

ANS: C REF: Chap 1 (Pemphigus vulgaris/etiology and pathogenesis), p 11

ANS: C REF: Chap 1 (Pemphigus vulgaris/etiology and pathogenesis), p 11 Chapter 1: Vesiculobullous Diseases Test Bank MULTIPLE CHOICE 1. Intercellular deposits of IgG are consistently found in oral epithelium in which of the following? a. Cicatricial pemphigoid b. Lichen planus

More information

Contents. 1 Normal Anatomy Introduction... 17

Contents. 1 Normal Anatomy Introduction... 17 Contents 1 Normal Anatomy... 1 Introduction... 1 Surface Landmarks... 1 Oral Mucosa... 1 Tongue... 4 Floor of Mouth... 6 Palate... 7 Dentition... 7 Temporomandibular Joint... 9 Innervation... 10 Jaws and

More information

IN THE NAME OF GOD. Dr.kheirandish DDS,MSC Oral and maxillofacial pathology

IN THE NAME OF GOD. Dr.kheirandish DDS,MSC Oral and maxillofacial pathology IN THE NAME OF GOD Dr.kheirandish DDS,MSC Oral and maxillofacial pathology Dermatologic Diseases Chapter 16 ECTODERMAL DYSPLASIA o Two or more ectodermally derived anatomic structures fail to develop o

More information

Oral Manifestation in Patients diagnosed with Dermatological Diseases

Oral Manifestation in Patients diagnosed with Dermatological Diseases JCDP ORIGINAL RESEARCH Oral Manifestation in Patients diagnosed 10.5005/jp-journals-10024-2191 with Dermatological Diseases Oral Manifestation in Patients diagnosed with Dermatological Diseases 1 Sanjay

More information

Sign In: pemphigus.org/form

Sign In: pemphigus.org/form Pemphigus and Pemphigoid The Unique Role of the Dental Professional Dr. Carol Anne Murdoch Kinch Sign In: pemphigus.org/form The International Pemphigus & Pemphigoid Foundation (IPPF) kindly asks all attendees

More information

Stomatitis.

Stomatitis. Stomatitis http://www.entusa.com/oral_photographs/20080102-stomatitis-palate_small.jpg Oral inflammation and ulcers, known as stomatitis, may be mild and localized or severe and widespread. They are invariably

More information

Conflicts. Objectives. University of Texas Health Science Center at San Antonio. Pediatrics Grand Rounds 24 August Pediatric Dermatology 101

Conflicts. Objectives. University of Texas Health Science Center at San Antonio. Pediatrics Grand Rounds 24 August Pediatric Dermatology 101 Pediatric Dermatology 101 John C. Browning, MD, FAAD, FAAP Conflicts Investigator: ViroXis Advisor: ViroXis Advisory Board: TopMD Speaker: Galderma Objectives Understand the meaning and importance of cutaneous

More information

2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD

2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD 2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD Course 9148: Diagnosis and Treatment of Recurrent Oral Ulcers Friday, April 6 9 am - 12 pm Diagnosis and Treatment of Recurrent Oral Ulcers

More information

A CASE REPORT OF: PSEUDOMEMBRANOUS CANDIDIASIS INDUCED BY LONG TERM SYSTEMIC CORTICOSTEROIDS THERAPY

A CASE REPORT OF: PSEUDOMEMBRANOUS CANDIDIASIS INDUCED BY LONG TERM SYSTEMIC CORTICOSTEROIDS THERAPY Case Report International Journal of Dental and Health Sciences Volume 02, Issue 02 A CASE REPORT OF: PSEUDOMEMBRANOUS CANDIDIASIS INDUCED BY LONG TERM SYSTEMIC CORTICOSTEROIDS THERAPY Ziad Salim Abdul

More information

Proceedings of the Southern European Veterinary Conference - SEVC -

Proceedings of the Southern European Veterinary Conference - SEVC - Close this window to return to IVIS www.ivis.org Proceedings of the Southern European Veterinary Conference - SEVC - Sep. 30-Oct. 3, 2010, Barcelona, Spain Next SEVC Conference: Sep. 30-Oct. 2, 2011 -

More information

The Oral Cavity. Image source:

The Oral Cavity. Image source: The Oral Cavity Anatomy Image source: http://anatomyforlayla.blogspot.co.za/2007/04/blog-post.html The major structures of the oral cavity are the lips, the teeth, the alveolar ridges (bony areas that

More information

WOMEN'S INTERAGENCY HIV STUDY ORAL PROTOCOL FORM OP 4: ORAL MUCOSAL TISSUE EXAM

WOMEN'S INTERAGENCY HIV STUDY ORAL PROTOCOL FORM OP 4: ORAL MUCOSAL TISSUE EXAM WOMEN'S INTERAGENCY HIV STUDY ORAL PROTOCOL FORM OP 4: ORAL MUCOSAL TISSUE EXAM COMPLETING THE FORM GENERAL INFORMATION Affix the Participant ID label in the space indicated. Record the visit number. Be

More information

الطلاوة = Leukoplakia LEUKOPLAKIA

الطلاوة = Leukoplakia LEUKOPLAKIA LEUKOPLAKIA Leukoplakia is a clinical term that refers to a predominantly white lesion of the oral mucosa that cannot be rubbed off or characterized by any other definable lesion or known disease. 130

More information

Available online at International Journal of Current Research Vol. 8, Issue, 10, pp , October, 2016 CASE STUDY

Available online at   International Journal of Current Research Vol. 8, Issue, 10, pp , October, 2016 CASE STUDY z Available online at http://www.journalcra.com International Journal of Current Research Vol. 8, Issue, 10, pp.39962-39967, October, 2016 INTERNATIONAL JOURNAL OF CURRENT RESEARCH ISSN: 0975-833X CASE

More information

Clinical Mucosal Immunology

Clinical Mucosal Immunology Clinical Mucosal Immunology Natural caries immunology in human It is sure, there is natural anti-caries immunity in human. Persons with low caries frequency have high anti-s.mutans IgG antibody level in

More information

Skin lesions & Abrasions

Skin lesions & Abrasions Skin lesions & Abrasions What Are Skin Lesions? A skin lesion is a part of the skin that has an abnormal growth or appearance compared to the skin around it Types of Skin Lesions Two types of skin lesions

More information

BLOCK 12 Viruses of the ENT

BLOCK 12 Viruses of the ENT BLOCK 12 Viruses of the ENT Acute infections Introduction Pharyngitis, Common cold, Sinusitis, Otitis media Recurrent infections Herpes zoster oticus Chronic infections HIV and ENT manifestations Neoplasms

More information

Premalignant lesions may expose to a promoting. factor & may be induced to undergo malignant. Carcinoma in situ displays the cytologic features of

Premalignant lesions may expose to a promoting. factor & may be induced to undergo malignant. Carcinoma in situ displays the cytologic features of بسم رلاهللا Def. Premalignant lesions may expose to a promoting factor & may be induced to undergo malignant transformation. Carcinoma in situ displays the cytologic features of malignancy without invasion

More information

Differential Diagnosis of Oral Lesions. An Interactive Lecture Using Audience Response Polling. John L. Alonge, MS, DDS

Differential Diagnosis of Oral Lesions. An Interactive Lecture Using Audience Response Polling. John L. Alonge, MS, DDS Differential Diagnosis of Oral Lesions An Interactive Lecture Using Audience Response Polling John L. Alonge, MS, DDS Goals 1. Review the diagnostic process needed to formulate a differential diagnosis

More information

Infection Causing Oral Ulceration

Infection Causing Oral Ulceration TITLE: Ulcerations of the Oral Cavity SOURCE: Grand Rounds Presentation, UTMB, Dept. of Otolaryngology DATE: March 31, 2009 RESIDENT PHYSICIAN: David Gleinser, MD FACULTY ADVISOR: Susan McCammon, MD SERIES

More information

INFLAMMATORY DISEASES PART I. Immunopathology Part I

INFLAMMATORY DISEASES PART I. Immunopathology Part I INFLAMMATORY DISEASES PART I Immunopathology Part I Nonspecific & T Cell Mediated Mucosal Inflammatory Lesions Nonspecific and Idiopathic Mucositis Hypersensitivity and Autoimmune T cell mediated Immunoglobulin

More information

Differential Diagnosis of Oral Ulcerations

Differential Diagnosis of Oral Ulcerations Differential Diagnosis of Oral Ulcerations Dr. Nagamani Narayana Department of Oral Biology University of Nebraska Medical Center College of Dentistry Objectives Differential diagnosis of oral ulcerations

More information

Inflammatory Disease. Part I. Infections

Inflammatory Disease. Part I. Infections Inflammatory Disease Part I Infections Bacterial, Fungal and Viral Infections of the Head and Neck Sexually Transmitted Diseases Lomaki, Middle Mesa Petroglyphs Northern Arizona Herpesviruses I, II Clamydia

More information

Oral Pemphigus Vulgaris: Case Report

Oral Pemphigus Vulgaris: Case Report Oral Pemphigus Vulgaris Rai A. et al 367 CASE REPORT Oral Pemphigus Vulgaris: Case Report Rai Arpita 1, Arora Monica 2, Naikmasur Venkatesh 3, Sattur Atul 3, Malhotra Varun 2 ABSTRACT BACKGROUND: Pemphigus

More information

A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions

A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions Continuing Education Brought to you by A Guide to Clinical Differential Diagnosis of Oral Mucosal Lesions Course Author(s): Michael W. Finkelstein, DDS, MS; Emily Lanzel, DDS, MS; John W. Hellstein, DDS,

More information

Benign Oral cavity lesions. Mohammed ALESSA MBBS,FRCSC Assistant Professor Consultant Otolaryngology, Head & Neck Surgery

Benign Oral cavity lesions. Mohammed ALESSA MBBS,FRCSC Assistant Professor Consultant Otolaryngology, Head & Neck Surgery Benign Oral cavity lesions Mohammed ALESSA MBBS,FRCSC Assistant Professor Consultant Otolaryngology, Head & Neck Surgery Anatomy Histology Physiology Pathology Clinical cases Introduction The oral cavity

More information

THE TONGUE. In Clinical Diagnosis

THE TONGUE. In Clinical Diagnosis THE TONGUE In Clinical Diagnosis A Colour Atlas of The Tongue in Clinical Diagnosis D.W. BEAVEN S.E. BROOKS BATES Guide to Physical Examination Lynn s. Bickley רויטל רחימי, תום כספי פנימית ב', תל-השומר

More information

When your patient complains of

When your patient complains of WILLIAM LAWSON, MD, DDS Mount Sinai School of Medicine ABSTRACT: Certain clues can help you identify the cause of bullous oral lesions. Diffuse oral and labial bullous erosions, sometimes accompanied by

More information

Clinical Manifestations of HIV

Clinical Manifestations of HIV HIV Symptoms Diane Havlir, MD Professor of Medicine and Chief, HIV/AIDS Division University of California, San Francisco (UCSF) WorldMedSchool; July 2, 2013 1 Clinical Manifestations of HIV! Result from

More information

Oral Pathology Syllabus for English-Speaking Students

Oral Pathology Syllabus for English-Speaking Students Oral Pathology Syllabus for English-Speaking Students Academic Hours Academic Hours in Years and Semesters I year II year III year IV year V year DISCIPLINE Semester Exam Total Lectures Practicals I II

More information

Tissue Conditions and the

Tissue Conditions and the Management of Oral Soft Tissue Conditions and the Use of Medications 29 August 2017 Mike Brennan DDS, MHS Department of Oral Medicine Carolinas Medical Center Charlotte, NC Objectives Differential diagnosis

More information

Alphaherpesvirinae. Simplexvirus (HHV1&2/ HSV1&2) Varicellovirus (HHV3/VZV)

Alphaherpesvirinae. Simplexvirus (HHV1&2/ HSV1&2) Varicellovirus (HHV3/VZV) Alphaherpesvirinae Simplexvirus (HHV1&2/ HSV1&2) Varicellovirus (HHV3/VZV) HERPES SIMPLEX VIRUS First human herpesvirus discovered (1922) Two serotypes recognised HSV-1 & HSV-2 (1962) HSV polymorphism

More information

Vascular. Extravasated blood. Melanocytic. Tattoo. Epidermolysis bullosa. Lichen planus. Pemphigoid Pemphigus Lupus. Candidosis. Surface Epithelial

Vascular. Extravasated blood. Melanocytic. Tattoo. Epidermolysis bullosa. Lichen planus. Pemphigoid Pemphigus Lupus. Candidosis. Surface Epithelial Oral Soft Tissue Pathology Epithelial Thickening (white) Combination Erythema migrans Epithelial atrophy (red) Surface Lesions Clinical Impression Enlargements Surface Debris Pigmented Vesicular Ulcerated

More information

Allergic contact stomatitis is a rare disorder,

Allergic contact stomatitis is a rare disorder, Allergic Contact Stomatitis: A Case Report and Review of Literature P Lokesh, T Rooban, Joshua Elizabeth, K Umadevi, K Ranganathan Abstract Allergic contact stomatitis is a well-recognized entity, which

More information

DERMATOLOGY SKIN DISEASE: APPROACH TO DIAGNOSIS

DERMATOLOGY SKIN DISEASE: APPROACH TO DIAGNOSIS DERMATOLOGY SKIN DISEASE: APPROACH TO DIAGNOSIS History Clinical Examination List and Prioritise Differentials Diagnostic Testing/Trials (eg Treatment Trial) Correlate All Findings History Signalment age,

More information

RECORD or PRINT THE CONFIRMATION ID This unique ID is displayed upon successful submission of your answer form.

RECORD or PRINT THE CONFIRMATION ID This unique ID is displayed upon successful submission of your answer form. 2013 course two self-study course The Ohio State University College of Dentistry is a recognized provider for ADA CERP credit. ADA CERP is a service of the American Dental Association to assist dental

More information

Tanzania Dental Journal Vol. 15 No. 1, May 2008

Tanzania Dental Journal Vol. 15 No. 1, May 2008 Diagnosis of Oral Lesions associated with HIV/AIDS Hamza O. Department of Oral Surgery and Oral Pathology, MUHAS Hamza O: Diagnosis of Oral Lesions associated with HIV/AIDS. Tanz Dent J 2008; 15 (1): 22-26

More information

WHITE LESIONS OF THE UPPER AIRWAY

WHITE LESIONS OF THE UPPER AIRWAY WHITE LESIONS OF THE UPPER AIRWAY WHITE LESION CONFIGURATIONS Solitary vrs Multifocal Flat Plaque Verrucous/rippled Lacey White with red component Papular (curdled milk plaques) Pseudomembranous PLAQUES

More information

Oral Medicine in 2011

Oral Medicine in 2011 Oral Medicine in 2011 and Denis P. Lynch, D.D.S., Ph.D. denis.lynch@marquette.edu Outline Recurrent human herpes virus, Type 1 Aphthous ulcers Lichen planus Oral cancer Candidiasis Xerostomia 1 Synopsis

More information

Diagnosis and management of COMMON NON-VIRAL ORAL ULCERATIONS

Diagnosis and management of COMMON NON-VIRAL ORAL ULCERATIONS and management of COMMON NON-VIRAL ORAL ULCERATIONS Van Heerden WFP, BChD, MChD (Oral Path), FC Path(SA) Oral Path, PhD, DSc Department of Oral Pathology, University of Pretoria Boy SC, BChD, MChD (Oral

More information

Pigmented lesions of the Oral cavity

Pigmented lesions of the Oral cavity Oral medicine أ.م.د احسان عبد هللا كميل Pigmented lesions of the Oral cavity Pigmented oral lesions are a large group of disorders in which the dark or brown color is the essential clinical characteristic.

More information

COPYRIGHTED MATERIAL. Introduction CHAPTER 1. Introduction

COPYRIGHTED MATERIAL. Introduction CHAPTER 1. Introduction CHAPTER 1 Introduction OVERVIEW The clinical features of skin lesions are related to the underlying pathological processes. Broadly skin conditions fall into three clinical groups: (a) those with a well-defined

More information

Role of the Dental Hygienist in Oral Pathology. Role of the Dental Hygienist in Oral Pathology. Cancers of the Oral Cavity.

Role of the Dental Hygienist in Oral Pathology. Role of the Dental Hygienist in Oral Pathology. Cancers of the Oral Cavity. Gum Gardeners Study Club April 25, 2016 Early Detection of Oral Cancer Cindy Kleinegger, DDS, MS NW Oral Pathology Tigard, OR nworalpathology.com Role of the Dental Hygienist in Oral Pathology Work closely

More information

Opportunistic Mycoses

Opportunistic Mycoses CANDIDIASIS SOFYAN LUBIS DEPARTEMEN MIKROBIOLOGI FAK.KEDOKTERAN USU MEDAN 2009 Opportunistic Mycoses Opportunistic mycoses are fungal infections that do not normally cause disease in healthy people, but

More information

Learning Objectives. History 8/1/2016. An Approach to Pediatric Rashes

Learning Objectives. History 8/1/2016. An Approach to Pediatric Rashes An Approach to Pediatric Rashes Neethi Patel, D.O. Learning Objectives 1.To identify common features of rashes seen in the pediatric population as well as pathognomonic features of certain pathologies

More information

APHTHOUS STOMATITIS ADULT & PEDIATRIC

APHTHOUS STOMATITIS ADULT & PEDIATRIC DEFINITION Aphthous stomatitis or canker sores are described as ulcers and inflammation of the tissues of the mouth, including the lips, buccal mucosa, tongue, gingiva, and posterior pharyngeal wall. These

More information

a. viral INFECTIONS OF ORAL MUCOSA HERPETIC STOMATITIS HERPETIC STOMATITIS

a. viral INFECTIONS OF ORAL MUCOSA HERPETIC STOMATITIS HERPETIC STOMATITIS a. viral INFECTIONS OF ORAL MUCOSA laboratory confirmation rather long diagnosis based mainly on clinical features basic diagnostic methods: (1) culture of viral particles; (2) morphologic changes and

More information

Oral cavity cancer accounts for approximately 3% of all malignancies and is a significant worldwide health problem.

Oral cavity cancer accounts for approximately 3% of all malignancies and is a significant worldwide health problem. Oral cavity cancer accounts for approximately 3% of all malignancies and is a significant worldwide health problem. Majority are SCC ( 5-year survival rate only about 50-60% ) Many SCC arrive from premalignant

More information

From the Cradle to the Grave: Oral pathology through the life span

From the Cradle to the Grave: Oral pathology through the life span From the Cradle to the Grave: Oral pathology through the life span Conditions Exhibited in Infants and Children: Dental Lamina Cysts Etiology: Developmental Clinical appearance: Cystic nodules on alveolar

More information

PAEDIATRIC ACUTE CARE GUIDELINE. Herpes Stomatitis

PAEDIATRIC ACUTE CARE GUIDELINE. Herpes Stomatitis Princess Margaret Hospital for Children PAEDIATRIC ACUTE CARE GUIDELINE Herpes Stomatitis Scope (Staff): Scope (Area): All Emergency Department Clinicians Emergency Department This document should be read

More information

Chapter 8. Otolaryngological Manifestations of AIDS

Chapter 8. Otolaryngological Manifestations of AIDS Chapter 8. Otolaryngological Manifestations of AIDS Acquired immunodeficiency syndrome (AIDS) first came to medical attention in the early 1980s, when an isolated number of deaths from rare lung infections

More information

Diagnostic sieve. Looking Beyond the Vermillion Border. Time bombs for medical GPs! Normal oral mucosa

Diagnostic sieve. Looking Beyond the Vermillion Border. Time bombs for medical GPs! Normal oral mucosa Sat 12 June 2010 Millennium WS 28 + 38 2.00-2.55; 3.05-4.00 PM Looking Beyond the Vermillion Border Laurence J. Walsh BDSc, PhD, DDSc, FFOP(RCPA), GCEd, FICD, FPFA, FADI, FIADFE The University of Queensland

More information

RISK FACTORS OF BURNING MOUTH SYNDROME: UN UPDATE

RISK FACTORS OF BURNING MOUTH SYNDROME: UN UPDATE RISK FACTORS OF BURNING MOUTH SYNDROME: UN UPDATE Cristina Popa, Carmen Stelea, Eugenia Popescu Department of Oral and Maxilo-facial Surgery Abstract: Burning mouth syndrome has never been associated with

More information

b) SKILLS The student should be able to

b) SKILLS The student should be able to 1. GOAL The aim of teaching the undergraduate student in Dermatology, S.T.D. and Leprology is to impart such knowledge and skills that may enable him to diagnose and treat common ailments and to refer

More information

A. Erythema multiforme and related diseases

A. Erythema multiforme and related diseases Go Back to the Top To Order, Visit the Purchasing Page for Details Chapter Erythema, Erythroderma (Exfoliative Dermatitis) Erythema is caused by telangiectasia or hyperemia in the papillary and reticular

More information

Manifestations of Acute Herpetic Gingivostomatitis in Human Immunodeficiency Virus: Positive Patients S K Narendra 1, N C Sahani 2, D N Moharana 3

Manifestations of Acute Herpetic Gingivostomatitis in Human Immunodeficiency Virus: Positive Patients S K Narendra 1, N C Sahani 2, D N Moharana 3 Received: 16 th October 2015 Accepted: 13 th January 2016 Conflict of Interest: None Source of Support: Nil Original Research Doi: 10.2047/jioh-08-04-10 Manifestations of Acute Herpetic Gingivostomatitis

More information

B. Autoimmune blistering diseases

B. Autoimmune blistering diseases Go Back to the Top To Order, Visit the Purchasing Page for Details formation immediately above the basal layer. The dermal papillae, which are covered by basal cells in the single layer that is left in

More information

DERMATOLOGICAL EMERGENCIES. DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE

DERMATOLOGICAL EMERGENCIES. DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE DERMATOLOGICAL EMERGENCIES DR. Ian Hoyle MBBS DIP IMC RCS (Ed), DA (UK),FRACGP,FACRRM,DIP DERM(Wales) TASMANIAN SKIN AND BODY CENTRE Dermatological Emergencies INFECTIONS ERYTHRODERMA DRUG ERUPTIONS STEVENS-JOHNSON

More information

Cases of Non-Infectious Vulvovaginitis

Cases of Non-Infectious Vulvovaginitis Cases of Non-Infectious Vulvovaginitis 2 nd PANHELLANIC CONGRESS on Lower Genital Tract Disorders December 14-16 Grand Hyatt Athens Lynette J. Margesson MD FRCPC Assistant Professor of Obstetrics & Gynecology

More information

2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD

2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD 2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD Course 9121: Infectious Hazards in Dentistry or What You Never Thought You'd Have to Worry about after You Passed National Boards Thursday,

More information

MUCOCUTANEOUS LESIONS Normal structures in epithelium cell adhesion to each other and to underlying connective tissue:

MUCOCUTANEOUS LESIONS Normal structures in epithelium cell adhesion to each other and to underlying connective tissue: ORAL DERMATOSES AND MUCOSAL/GINGIVAL LESIONS MUCOCUTANEOUS LESIONS Normal structures in epithelium cell adhesion to each other and to underlying connective tissue: Diagram taken from: Oral and Maxillofacial

More information

Kings College London Dental Institute. Guy s & St Thomas NHS Foundation Trust Oral Medicine Unit. Disease Activity Scoring sheets

Kings College London Dental Institute. Guy s & St Thomas NHS Foundation Trust Oral Medicine Unit. Disease Activity Scoring sheets Kings College London Dental Institute Guy s & St Thomas NHS Foundation Trust ral Medicine Unit Disease Activity Scoring sheets Clinical scoring systems for oral mucosal Diseases The routine clinical management

More information

DURATION OF THE STUDY: JUNE-OCTOBER 2008 COST OF STUDY; 9400KSH SOURCE OF FUNDS: SELF INVESTIGATOR: GIKUNDA MARY KATHURE

DURATION OF THE STUDY: JUNE-OCTOBER 2008 COST OF STUDY; 9400KSH SOURCE OF FUNDS: SELF INVESTIGATOR: GIKUNDA MARY KATHURE J ORAL MANIFESTATIONS OF HIV INFECTION/AIDS AND THEIR INFLUENCE ON ORAL FUNCTIONS AND ORAL HYGIENE PRACTICES AMONG ADULT PATIENTS IN KENYATTA NATIONAL HOSPITAL COMPREHENSIVE CARE CENTRE. INVESTIGATOR:

More information

Introduction. Study of fungi called mycology.

Introduction. Study of fungi called mycology. Fungi Introduction Study of fungi called mycology. Some fungi are beneficial: ex a) Important in production of some foods, ex: cheeses, bread. b) Important in production of some antibiotics, ex: penicillin

More information

Title: An unusual presentation of Erythema Multiforme in a paediatric patient. A. BaniHani *., H. Nazzal*., L. Webb*., KJ. Toumba. *, G. Fabbroni*.

Title: An unusual presentation of Erythema Multiforme in a paediatric patient. A. BaniHani *., H. Nazzal*., L. Webb*., KJ. Toumba. *, G. Fabbroni*. Title: An unusual presentation of Erythema Multiforme in a paediatric patient. A. BaniHani *., H. Nazzal*., L. Webb*., KJ. Toumba. *, G. Fabbroni*. Abstract: Background Erythema multiforme (EM) is an acute,

More information

Oral Medicine FULL Referral Guide (FRG)

Oral Medicine FULL Referral Guide (FRG) Oral Medicine FULL Referral Guide (FRG) Yorkshire & the Humber February 2017 Version 1 Contents Introduction... 1 Oral Medicine Referral Decision Process 1 Step 1. Oral Medicine Condition?... 2 A. Soft

More information

Dental Care and Health An Update. Dr. Ranjini Pillai, DDS, MPH, FAGD, FICOI

Dental Care and Health An Update. Dr. Ranjini Pillai, DDS, MPH, FAGD, FICOI Dental Care and Health An Update Dr. Ranjini Pillai, DDS, MPH, FAGD, FICOI WHO s Definition of Health? Health is a state of complete physical, mental, and social wellbeing and not merely the absence of

More information

Emergency Dermatology. Emergency Dermatology

Emergency Dermatology. Emergency Dermatology Emergency Dermatology These are rapidly progressive skin conditions and some are potentially lifethreatening. Early recognition is important to implement prompt supportive care and therapy. Some are drug

More information

Plasma Cell Gingivitis Among Herbal Toothpaste Users: A Report of Three Cases

Plasma Cell Gingivitis Among Herbal Toothpaste Users: A Report of Three Cases Plasma Cell Gingivitis Among Herbal Toothpaste Users: A Report of Three Cases Abstract Aim: The aim of this article is to present a brief review of plasma cell gingivitis (PCG) along with reports of three

More information

Squamous Cell Neoplasia and Precursor Lesions

Squamous Cell Neoplasia and Precursor Lesions Squamous Cell Neoplasia and Precursor Lesions Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory Medicine University of Arkansas for Medical

More information

Objectives. Terminology. Recognize common pediatric dermatologic conditions. Review treatment plans Identify skin manifestations of systemic disease

Objectives. Terminology. Recognize common pediatric dermatologic conditions. Review treatment plans Identify skin manifestations of systemic disease Pediatric Visual Dermatological Diagnosis Fernando Vega, M.D. Objectives Recognize common pediatric dermatologic conditions Expand differential diagnosis Review treatment plans Identify skin manifestations

More information

Pemphigus in younger age group in Bangladeshi population

Pemphigus in younger age group in Bangladeshi population ORIGINAL ARTICLE in younger age group in Bangladeshi population Abdul Wahab 1, MD, Lubna Khondker 1, MD, Jamal Uddin 1, MD, Ishrat Bhuiyan 2, MD Shirajul Islam Khan 3, MD, Zafrul Islam 1, MD, Rahmat Ali

More information

A. Viral infections whose main symptom is blistering

A. Viral infections whose main symptom is blistering Go Back to the Top To Order, Visit the Purchasing Page for Details Chapter Viral Infections A virus is a particle of DNA or RNA enclosed by structural proteins. Viruses infect cells and proliferate to

More information

RECORD or PRINT THE CONFIRMATION ID This unique ID is displayed upon successful submission of your answer form.

RECORD or PRINT THE CONFIRMATION ID This unique ID is displayed upon successful submission of your answer form. 2014 course two self-study course The Ohio State University College of Dentistry is a recognized provider for ADA, CERP, and AGD Fellowship, Mastership and Maintenance credit. ADA CERP is a service of

More information

CAMOSUN COLLEGE School of Health & Human Services Dental Programs. DHYG 321 Oral Science COURSE OUTLINE

CAMOSUN COLLEGE School of Health & Human Services Dental Programs. DHYG 321 Oral Science COURSE OUTLINE CAMOSUN COLLEGE School of Health & Human Services Dental Programs 2013 COURSE OUTLINE 1. Instructor Information (a) Instructor Lynne Viczko (b) Office hours Posted on office door (c) Location Dental Building

More information

EPIDERMOLYSIS BULLOSA

EPIDERMOLYSIS BULLOSA EPIDERMOLYSIS BULLOSA Definition Epidermolysis bullosa (EB) is a term used to describe a group of rare mainly hereditary, chronic, non-inflammatory diseases of skin and mucous membranes. EB is characterized

More information

Mucous membrane pemphigoid in a patient with hypertension treated with atenolol: a case report

Mucous membrane pemphigoid in a patient with hypertension treated with atenolol: a case report Kanjanabuch et al. Journal of Medical Case Reports 2012, 6:373 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Mucous membrane pemphigoid in a patient with hypertension treated with atenolol: a

More information

http://www.savinglivesuk.com/ HIV Awareness Study Morning 24 th November 2017 Agenda HIV Basics & Stages of HIV HIV Testing, Health Advising & Sexual Health Saving Lives Antiretroviral Medication Antenatal/Postnatal

More information

Immunofluorescence in Oral Dermatological Disorders- No Shiny Matter

Immunofluorescence in Oral Dermatological Disorders- No Shiny Matter Journal of Academy of Dental Education Journal of Academy of Dental Education, 24-28, DOI: 10.18311/jade/2015-2016/15951 ISSN (Print): 2348-1595 ISSN (Online) : 2348-2621 Immunofluorescence in Oral Dermatological

More information

ULCERATIVE,VESICULAR, AND BULLOUS LESIONS

ULCERATIVE,VESICULAR, AND BULLOUS LESIONS 4 ULCERATIVE,VESICULAR, AND BULLOUS LESIONS MARTIN S. GREENBERG, DDS THE PATIENT WITH ACUTE MULTIPLE LESIONS Herpesvirus Infections Primary Herpes Simplex Virus Infections Coxsackievirus Infections Varicella-Zoster

More information

EXANTHEMATOUS ILLNESS. IAP UG Teaching slides

EXANTHEMATOUS ILLNESS. IAP UG Teaching slides EXANTHEMATOUS ILLNESS 1 DEFINITIONS Exanthema eruption of the skin Exanthema eruption of mucosae Macule flat nonpalpable lesion Papule small palpable lesion Nodule large palpable lesion Vesicle small fluid

More information

Immunobullous Diseases: Review and Update. May P. Chan, MD Associate Professor of Pathology and Dermatology University of Michigan

Immunobullous Diseases: Review and Update. May P. Chan, MD Associate Professor of Pathology and Dermatology University of Michigan Immunobullous Diseases: Review and Update May P. Chan, MD Associate Professor of Pathology and Dermatology University of Michigan Diagnosis of Immunobullous Diseases Clinical H&E DIF DIAGNOSIS IIF ELISA

More information

Oral Cancer Dr Christine Goodall Consultant Oral Surgeon University of Glasgow Dental School

Oral Cancer Dr Christine Goodall Consultant Oral Surgeon University of Glasgow Dental School Oral Cancer Dr Christine Goodall Consultant Oral Surgeon University of Glasgow Dental School christine.goodall@glasgow.ac.uk Locations Lip, mouth, oropharynx Tongue, floor of mouth, buccal mucosa, palate,

More information

To provide guidance on prevention and control of illness caused by varicella-zoster virus (VZV).

To provide guidance on prevention and control of illness caused by varicella-zoster virus (VZV). Effective Date: 04/18 Replaces: 0 4 / 1 3 / 1 7 Page 1 of 4 POLICY: To provide guidance on prevention and control of illness caused by varicella-zoster virus (VZV). DEFINITIONS Two syndromes occur from

More information

Emergency Dermatology Dr Melissa Barkham

Emergency Dermatology Dr Melissa Barkham Emergency Dermatology Dr Melissa Barkham Spotlight Seminar 30 th September 2010 Why is this important? Urgent recognition and treatment of dermatologic emergencies can be life saving and prevent long term

More information

Oral infections. Siri Beier Jensen Associate Professor, DDS, PhD

Oral infections. Siri Beier Jensen Associate Professor, DDS, PhD Oral infections Siri Beier Jensen Associate Professor, DDS, PhD Oral mucosa Covers and protects underlying structures Barrier to bacterial, fungal and viral infection Resistant to: Temperature ph Mechanical

More information

Pododermatitis. (Inflammation of Skin of the Paws) Basics OVERVIEW SIGNALMENT/DESCRIPTION OF PET SIGNS/OBSERVED CHANGES IN THE PET

Pododermatitis. (Inflammation of Skin of the Paws) Basics OVERVIEW SIGNALMENT/DESCRIPTION OF PET SIGNS/OBSERVED CHANGES IN THE PET Pododermatitis (Inflammation of Skin of the Paws) Basics OVERVIEW Podo- refers to the feet or paws; dermatitis is the medical term for inflammation of the skin Pododermatitis is an inflammatory, multifaceted

More information

Human Immunodeficiency Virus and Oral Health

Human Immunodeficiency Virus and Oral Health REVIEW Human Immunodeficiency Virus and Oral Health Shitanshu Malhotra 1 and Pallavi Singh 2 Quick Response Code doi: 10.5866/2014.611460 1&2 PG Student Department Of Public Health Dentistry Babu Banarasi

More information

04/09/2018. Squamous Cell Neoplasia and Precursor Lesions. Agenda. Squamous Dysplasia. Squamo-proliferative lesions. Architectural features

04/09/2018. Squamous Cell Neoplasia and Precursor Lesions. Agenda. Squamous Dysplasia. Squamo-proliferative lesions. Architectural features Squamous Cell Neoplasia and Precursor Lesions Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory Medicine University of Arkansas for Medical

More information