Drug-induced oral ulcer
Pathogenetic mechanisms include focal irritation due to low pH (aspirin), allergic hypersensitivity (gold, NSAIDs), or cytotoxicity (antimetabolites).
Medications with strong evidence for antimetabolic injury of oral mucosal epithelium include 5-fluorouracil, 6-mercaptopurine, methotrexate, bleomycin, doxorubicin, daunorubicin, and actinomycin-D. Immune-mediated mechanisms, resulting in an ulcerative lichenoid reaction, have been described for a wide range of systemic medications, including captopril, carbamazepine, methyldopa, naproxen, indomethacin, zomepirac, lithium, and prochlorperazine, although this is an ever-expanding list. Similar lesions can be induced locally by mercury salts associated with large deteriorating amalgam (silver) dental fillings that contact the buccal or lingual mucosa.
T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter
403665005 – Drug-induced oral ulceration
- Lichen planus
- Erythema multiforme
- Stevens-Johnson syndrome / toxic epidermal necrolysis
- Aphthous ulcers
- Behçet syndrome
- Pemphigus vulgaris
- Lupus erythematosus (see also oral lupus erythematosus)
- Cicatricial pemphigoid
- Paraneoplastic pemphigus
- Contact stomatitis (eg, artificial cinnamon flavoring)
- Graft-versus-host disease