ERYTHEMATOUS ORAL MUCOSAL LESIONS IN PEDIATRIC PATIENTS

Erythematous lesions of the oral mucosa in pediatric patients encompass a heterogeneous spectrum of conditions arising from epithelial, inflammatory, vascular, or hemorrhagic changes. Epithelial thinning, loss of keratinization, and mucosal atrophy may increase the visibility of the underlying vascular plexus, whereas vasodilation, hyperemia, increased blood flow, and erythrocyte extravasation may further contribute to mucosal redness. Vascular abnormalities may also present as persistent bright-red to violaceous lesions.

In children, erythematous oral lesions may appear as localized or diffuse areas of redness and may be associated with erosions, ulcers, papules, or vascular changes. Their etiology is broad and includes traumatic, inflammatory, infectious, immune-mediated, hematologic, and vascular disorders, as well as, less commonly, neoplastic conditions. Clinical presentation varies according to morphology, color, consistency, anatomical distribution, associated symptoms, and temporal evolution.

A structured clinical assessment is essential for establishing an appropriate differential diagnosis. Particular attention should be given to lesion onset and duration, distribution, local and systemic symptoms, potential triggering factors, and associated medical conditions. This is especially relevant in pediatric patients, in whom clinical examination may be challenging and oral mucosal findings may differ from those observed in adults.

This presentation aims to provide a clinically oriented overview of the main erythematous oral mucosal lesions occurring in pediatric patients, with particular emphasis on their epidemiology, etiology, classification, clinical features, differential diagnosis, and therapeutic management. Improving recognition of these conditions may facilitate early diagnosis and support timely and appropriate clinical management.