Drug-Induced Stomatitis — NDEB AFK MCQ

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ModerateOral PathologyDrug-Induced StomatitisNDEB AFK

An elderly patient on long-term methotrexate develops painful oral ulcers. Which mechanism best explains this finding?

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Correct answer: E — Direct cytotoxic effect on rapidly dividing mucosal epithelium

Methotrexate is a folic acid antagonist that inhibits dihydrofolate reductase, impairing DNA synthesis. It is directly cytotoxic to rapidly dividing cells, including oral mucosal epithelium, causing stomatitis and painful ulceration. This is a common dose-related adverse effect. Folic acid supplementation can reduce the severity of methotrexate-induced stomatitis.

Reference: Neville – Oral and Maxillofacial Pathology, 4th ed., 2016