title: Long-standing oral ulcers: proposal for a new 'S-C-D classification system'.
abstract: Persistent oral ulcers and erosions can be the final common manifestation, sometimes clinically indistinguishable, of a diverse spectrum of conditions ranging from traumatic lesions, infectious diseases, systemic and local immune-mediated lesions up to neoplasms. The process of making correct diagnosis for persistent oral ulcers still represents a challenge to clinicians. Major diagnostic criteria should include the clinical appearance of both ulcer and surrounding non-ulcerated mucosa, together with the evaluation of associated signs and symptoms, such as: number (single or multiple), shape, severity of the ulcer(s), conditions of remaining mucosa (white, red or with vesiculo-bullous lesions) and systemic involvement (e.g. fever, lymphadenopathy or evaluation of haematological changes). The aim of this paper was to review the literature relating to persistent oral ulcers and provide a helpful, clinical-based diagnostic tool for recognising long-standing ulcers in clinical dental practice. The authors, therefore, suggest distinguishing simple, complex and destroying (S-C-D system) ulcerations, as each requires different diagnostic evaluations and management. This classification has arisen from studying the current English literature relating to this topic, performed using MEDLINE / PubMed / Ovid databases.
authors.affiliation: Department of Oral Sciences, University of Palermo, Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Compilato
authors.forename: N
authors.initials: N
authors.lastname: Cirillo
authors.forename: N
authors.initials: N
authors.lastname: Termine
authors.forename: A R
authors.initials: AR
authors.lastname: Kerr
authors.forename: C
authors.initials: C
authors.lastname: Paderni
authors.forename: D
authors.initials: D
authors.lastname: Ciavarella
authors.forename: G
authors.initials: G
authors.lastname: Campisi
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005151:Facial Injuries / Q000175:diagnosis; D006801:Humans; D017676:Lichen Planus, Oral / Q000175:diagnosis; D009062:Mouth Neoplasms / Q000175:diagnosis; D019226:Oral Ulcer / Q000145:classification* / Q000473:pathology*; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis