Oral Crohn Disease Features — MFDS Part 1 MCQ

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ModerateOral MedicineOral Crohn Disease FeaturesMFDS Part 1

Which combination of oral findings is most characteristic of Crohn disease and may be present before intestinal symptoms develop?

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Correct answer: E — Cobblestoned buccal mucosa, deep linear vestibular ulcers, and mucosal tags

Explanation lettering: E = shown as A · C = shown as B · D = shown as C · B = shown as D · A = shown as E

A is correct. Characteristic oral manifestations of Crohn disease include cobblestoning of the buccal mucosa, deep linear ulcers—often affecting the vestibular sulci—and indurated mucosal tags. Persistent lip or facial swelling is another recognised feature. Oral disease may precede gastrointestinal symptoms, particularly in younger patients. Angular cheilitis can occur but is non-specific and may reflect nutritional deficiency. Option B describes oral lichen planus or another immune-mediated desquamative disorder. Option C suggests a mucocutaneous pigmentation disorder rather than Crohn disease. Option D indicates salivary gland dysfunction, such as Sjögren syndrome. The pallor, depapillated tongue and angular cheilitis in option E are more suggestive of haematinic deficiency.

Reference: Muhvić-Urek M, Tomac-Stojmenović M, Mijandrušić-Sinčić B. Oral pathology in inflammatory bowel disease. World Journal of Gastroenterology. 2016;22:5655-5667. https://pubmed.ncbi.nlm.nih.gov/27433081/