stomatitismucositis

Stomatitismucositis is an inflammatory condition of the oral mucosa characterized by features of both stomatitis and mucositis. It is most commonly described as a complication of cancer therapy, particularly high-intensity chemotherapy and/or radiotherapy to the head and neck, but can also arise with other systemic treatments, infections, or systemic illnesses.

Clinical features include erythema, edema, and ulceration of the oral mucosa, often with pain (odynophagia), burning sensation, and difficulties with eating or swallowing. Patients may report altered taste, xerostomia, and secondary infections such as candidiasis or herpetic lesions. Severity ranges from mild mucosal erythema to extensive ulceration and functional impairment. Diagnosis is clinical, using established grading scales such as the WHO Oral Toxicity Scale or the National Cancer Institute CTCAE. Differential diagnosis includes aphthous ulcers, candidiasis, and drug-induced rashes.

Causes and risk factors include cytotoxic chemotherapy agents, head and neck radiotherapy, intensified treatment regimens, poor oral hygiene, tobacco and alcohol use, nutritional deficiency, and preexisting mucosal disease. Pathophysiology involves mucosal barrier injury with mucosal ulceration, inflammation, and potential infection.

Management focuses on symptom relief, infection control, and maintenance of nutrition. This includes meticulous oral care with gentle brushing, saline or bicarbonate rinses, and non-alcoholic mouthwashes; topical anesthetics or systemic analgesia; topical antifungals or antivirals as indicated by infection; and nutritional support. In select cases, growth factors such as palifermin or cryotherapy may be used to reduce risk during specific chemotherapy regimens.

Prevention emphasizes oral hygiene prior to therapy, preventive dental evaluation, and protective oral care during treatment. Prognosis generally improves after cessation or completion of causal therapy, but severe mucositis can delay cancer treatment and increase infection risk.