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Mouth signs in abdominal disease

Abnormal pigmentation	Addisons disease		Mouth and lips hyperpigmented
	Lichen planus		White lines and streaks inside mouth
	Peutz-Jegher's disease		Pigmented freckles around lips and inside mouth associated with intestinal intususseption and GI bleeds from colonic polyps Patients have increased incidence of concurrent malignancy of breast, lung and pancreas
	Hereditary telangectasia		Rendu-Olser-Weber disease Multiple telangectasia (dilated capillaries and venules) around mouth and tongue and lips Associated with GI bleeding due to AV malformations Group of autosomal dominant conditions
Ulceration	Acanthosis nigricans		Black discolouration of skin Associated with carcinoma of stomach and oesophagus, lymphomas, endocrine disorders
	Apthous ulcers		Smal, round, shallow Common in childhood and associated with infection and minor trauma to oral cavity IBD: coeliac disease, ulcers tend to be more persistent and much larger
	Behcet's disease		Rare autoimmune disease most common in young men Triad of genital and oral ulceration and anterior uveitis
	Herpes Simplex		Small vesicles with erythematous base on lips and inside mouth Diagnosed with scrapings of the base of the lesions Usually responsive to topical acyclovir
Lip disorders	Angular stomatitis		Chapping and splitting of corners of lips Associated with HSV, candida, iron, folate, vitamin B/C deficiencies
Infections	Herpes simplex
	Oral candidiasis		Creamy white patches that may be rubbed off In patients with sterois, oral antibiotic use, immunocompromised

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