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Pathology General 464b9e81

Snail track ulcer and cobblestone appearance are seen together in:

A
Secondary syphilis
B
Heck's disease
C
Tertiary syphilis
D
Pyostomatitis vegetans
High-Yield Explanation
In secondary syphilis, only snail track ulcers are seen. Hyperplastic lesions in Heck's disease are small (0.3–1.0 cm), discrete, and well-demarcated, but they frequently cluster so closely together that the entire mucosal area takes on a cobblestone or fissured appearance. Patients with pyostomatitis vegetans exhibit characteristic yellowish, slightly elevated, linear, serpentine pustules set on an erythematous oral mucosa. The lesions primarily affect the buccal and labial mucosa, soft palate, and ventral tongue. These lesions have been called “snail track” ulcerations, although in most instances, the lesions are probably not truly ulcerated.  The most frequently affected area was the buccal mucosa which presented a ‘cobblestone’ appearance, while the vestibular lesions appeared as folds and ulcers. Ref: Shafer's textbook of oral pathology 7th edition page 336-337

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