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mucositis

Inflammation of a mucous membrane Etiology: - oral mucositis is a common complication of chemotherapy & radiation therapy Clinical manifestations: - signs & symptoms generally start 4-7 days after administration of chemotherapy & 10 days after radiation therapy - inflammation on buccal mucosa labial mucosa, & ventral surface of tongue - early ulcerative changes often apparent by the end of the 2nd week of treatment - oropharyngeal pain, dysphagia, & loss of taste Complications: - mucositis predisposes patients to infections with Staphylococcus & Streptococcus mitis Management: supportive treatment [2] - salt & baking soda rinses - topical anesthetics (2% viscous lidocaine) - chlorhexidine without alcohol (0.12%) - 1/2 & 1/2 mixture of diphendydramine & milk of magnesia - topical corticosteroids for ulcers - adequate hydration, oral lubricants, humidified air - soft foot, protein & vitamin supplements - supplemental zinc to help loss of taste - avoidance of alcohol & tobacco - cleaning of dentures with antimicrobial solution [2] prevention - oral cryotherapy may be useful for prevention of oral mucositis in patients receiving bolus 5-FU chemotherapy or high-dose melphalan [6]

Specific

stomatitis (includes oral ulceration)

General

inflammation mucosal disease

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 15 American College of Physicians, Philadelphia 1998
  2. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  3. Peterson DE, Lalla RV. Oral mucositis: the new paradigms. Curr Opin Oncol. 2010 Jul;22(4):318-22. Review. PMID: 20485169
  4. Raber-Durlacher JE, Elad S, Barasch A. Oral mucositis. Oral Oncol. 2010 Jun;46(6):452-6. Review. PMID: 20403721
  5. Sonis ST. Oral mucositis. Anticancer Drugs. 2011 Aug;22(7):607-12. Review. PMID: 21709615
  6. Peterson DE, Ohrn K, Bowen J et al Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy. Support Care Cancer. 2013 Jan;21(1):327-32. Review. PMID: 22993025