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Fever, lesion, grey ulcers on cheeks, lips, lymph node swollen. Aphthous ulcer ?

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Internal Medicine Specialist
Practicing since : 1998
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Hi, I'm a 37 year old black male. Generally very healthy with exercise (surfing, martial arts) and a good diet. I recently got a fever (101-102.7F) less than 2 days ago. Yesterday, I noticed that the loose grey skin on my inner lower lip peeled away to reveal a red lesion. Now I'm noticing what seems to be multiple clusters of 3 or more of these grey ulcers with red borders ranging from 2mm to about 1 cm, on the lower lip, inner cheek on both sides, and a bit on the upper lip. There are dozens in total. My bottom lip is a bit swollen. I also have a swelling of the lymph node under my left jaw. Any guidance on what could be causing this? I think maybe aphthous ulcer, but what could it mean if accompanied by these other symptoms?
Posted Wed, 25 Apr 2012 in General Health
 
 
Answered by Dr. Jasvinder Singh 25 minutes later
Hello,

Thanks for posting your query. I can understand your concern for these symptoms. Two important possibilities which can present with such symptoms are :

1)     Gingivostomatitis which is an inflammation of the oral mucosa and gingival is common in young adults and has prodromal symptoms (fever, malaise, irritability, headache, vomiting, lymphadenopathy) 1-2 days prior to local lesions after which lesions appear inside the mouth forming small vesicles which rupture quickly, resulting in shallow, round, discrete ulcers with erythematous halo.

2)     Aphthous ulcers in response to an infection

In gingivostomatitis, symptoms usually resolve with fluid intake, good oral hygiene and gentle debridement of the mouth. Use chlorhexidine mouth wash and avoid acid drinks, like fruit juices or fizzy drinks, or drink them through a straw so they don't irritate your mouth. Also avoid spicy food and sharp food and citrus fuits.

You can use topical ointments like numbing ointments, such as benzocaine (Oragel), anti-inflammatory (steroid) gels, benadryl allergy liquid mouthwash, oral preparations of steroids and vitamin supplement. Oral pain killers like Ibuprofen also help. But all these medicines are available under prescription and should be taken under a doctor’s guidance.


Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.






Above answer was peer-reviewed by
 
Follow-up: Fever, lesion, grey ulcers on cheeks, lips, lymph node swollen. Aphthous ulcer ? 10 hours later
Thank you for your quick response. I have an additional question:

For each of these ailments, does treating the ulcers have any affect on the underlying ailment, or is it just a reaction? In gingivostomatitis, for example, it sounds as though the fever and the ulcers have the same source. Does that mean that it normally takes 1-2 weeks to relieve the fever symptoms as well as the sores? How about for aphthous ulcers as a response to an infection?
 
 
Answered by Dr. Jasvinder Singh 13 hours later
Hello,

Thanks for writing back.

Ulcers may be a response or a symptom of an underlying bacterial or viral infection and treating the ulcers will not lead to treatment of the underlying cause. Specific antibiotics or antivirals are needed to treat the symptoms.

Once specific treatment after confirming the diagnosis is started fever subsides quickly and then other symptoms may take a few days to subside. Like in case there is pain, pain may continue for seven to fourteen days, sometimes with worsening pain until the end. So other symptoms may take a bit longer than fever to subside.

Aphthous ulcers usually heal in 1 to 2 weeks but they tend to recur at intervals over the course of many years. Sometimes they can be much larger (more than a centimetre in diameter), and then they can take months to heal.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.

Above answer was peer-reviewed by
 
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