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Oral pathology > White Lesions > Flashcards

White Lesions Flashcards

1
Q

It presents a white soft plaque that can be wiped off leaving a painful erythematous eroded, ulcerated surface.

A

Acute Pseudomembranous Candidiasis

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2
Q

This is a common opportunistic oral mycotic infection that develops in the presence of one of several predisposing conditions.

A

Candidiasis

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3
Q

Give atleast 5 predisposing factors in which Candida albicans can produce a disease state (candidiasis)

A 
Immunodeficiency 
Diabetes mellitus
Pregnancy
Xerostomia
Poor oral hygiene
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4
Q

It is the most common clinical type of candidiasis

A

Acute pseudomembranous candidiasis

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5
Q

What are the favored sites of acute pseudomembranous candidiasis

A

Buccal mucosa
Mucobuccal folds
Oropharynx
Lateral aspect of tongue

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6
Q

Acute erythematous candidiasis is also known as _____

A

Antibiotic stomatitis

Antibiotic glossitis

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7
Q

This type of candidiasis commonly occurs in geriatric patients who wears complete maxillary dentures

A

Chronic erythematous candidiasis

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8
Q

This type of candidiasis has bright red, somewhat velvety to pebbly surface, with relatively little keratinization

A

Chronic erythematous candidiasis

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9
Q

This case is usually seen in individuals with denture-related candidiasis

A

Angular cheilitis

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10
Q

True of False

Chronic Candidal Infections are capable of producing a hyperplastic tissue response.

A

True

Chronic hyperplastic Candidiasis

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11
Q

Type of hyperplastic candidiasis that involves the dorsum of the tongue

A

Median rhomboid glossitis

  • Asymptomatic
  • found anterior to circumvallate papillae
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12
Q

Chronic candidiasis may give rise to leukoplakia.

And this indicates that CC is a precancerous state

A

1st statement is true

2nd statement is false

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13
Q

If seen microscopically, fungal hyphae are seen penetrating the upper layers of epithelium at acute angles

A

Acute candidiasis

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14
Q

Type of candidiasis where epithelial hyperplasia can be seen during microscopic examination

A

Chronic candidiasis

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15
Q

Give atleast 3 differential diagnosis of Candidiasis

A 
White:
Slough associated with chemical burns
Traumatic ulcerations
Mucous patches of syphilis
White keratotic lesions

Red:
Drug related reactions
DLE
Erosive lichen planus

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16
Q

Superficial burn in the oral mucosa that is caused by topical applications of chemicals

A

Mucosal burns

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17
Q

Mucosal Burns

Short term:
Long term exposure:

A

Short term: mild erythema

Long term exposure: white slough

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18
Q

The primary factor of this condition is chewing of areca (betel) nuts.

A

Submucous fibrosis

+ it is also caused by nutritional and vitamin deficiency

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19
Q

True or False

Oral submucous fibrosis is a premalignant disorder

A

True

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20
Q

What vitamin and mineral is deficient in persons with oral submucous fibrosis?

A

Vitami B complex

Iron

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21
Q

Presents a whitish yellow lesion which is chronic. It is usually located in the buccal mucosa and soft palate. It may cause difficulty in eating and trismus. Upon palpation, fibrous bands are easily palpable (stiff fibrous bands)

A

Oral submucous fibrosis

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22
Q 
Histological examination reveals:
atrophy of epithelium and subajacent fibrosis
Epithelial dysplasia
Poorly vascularized lamina propia
Diffused to mild inflammatory infiltrate
Type 1 collagen: submucosa
Type 3 collagen: epithelium- CT
A

Oral submucous fibrosis

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23
Q

Treatment for Oral submucous fibrosis

A

Stop betel nut chewing
Local injection of chymotrypsin, hyaluronidase, and dexamethasone
Surgical excision of the fibrous bands
Submucosal placement of vascularized free flap grafts

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24
Q

Oral submucous fibrosis will progress to _____

A

Squamous cell carcinoma

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25
Q

These are ectopic sebaceous glands or sebaceous choristoma (normal tissue in abnormal location)

A

Fordyce’s granules

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26
Q

Where are the sites of predilection of fordyce’s granules?

A

Buccal mucosa

Vermillion of the upper lip

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27
Q

These are lymphoid tissues that appears yellow or yellow-white which produces small, dome-shaped elevations
Located in the posterolateral aspect of tongue.

A

Ectopic lymphoid tissue

Known as lingual tonsil

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28
Q

Waldeyer’s ring includes:

A

Pharyngeal tonsil,
two tubal tonsils,
two palatine tonsils and the
lingual tonsils

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29
Q

Nonodontogenic neonatal cyst that occurs along the palatal midline (fusion of palatine shelves)

A

Epstein’s pearls (palate)

Gingival cyst of newborn

Bohn’s nodules

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30
Q

What case in similar to gingival cyst of adult?

A

Lateral periodontal cyst

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31
Q

Gingival cyst of adult is formed by the remnants of the dental lamina (rests of serrez)

A

True
Occurs at 50-60 y/o

At premolar and bicuspid (mandibular region)

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32
Q

Treatment of gingival cyst of infants and adult

A

Infants: none ; spontaneously ruptures
Adult: surgical excision

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33
Q

Painful pus in the gingiva which is derived from an infection at the base of the occluded periodontal pocket or apex of nonvital tooth

A

Parulis (gum boil)

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34
Q

Yellow or yellow-white uninflammed submucosal mass of adipose tissue

A

Lipoma

35
Q

What non epithelial white - yellow lesions does not required treatment?

A

Fordyce’s granule
Ectopic lymphoid tissue
Lipoma

36
Q

A hereditary generalized mild opacification of the buccal mucosa - variation of normal. Asymptomatic and symmetrical. Disappears when stretched.
It appears as gray-white, diffuse, filmy, or milky surface alterations

A

Leukoedema

37
Q

Differential Diagnosis for Leukoedema

A

White sponge nevus
HBID
Chronic cheek biting
Lichen planus

38
Q

This is an autosomal dominant condition (mutation in genes coding for keratin 4 and/or 13). It is asymptomatic and occurs before puberty. It does not disappear when cheeks are stretched and are bilateral

A

White Sponge Nevus

39
Q

Where do WSN usually occurs?

A

Buccal mucosa
Tongue
Vestibular mucosa

Esophagus
Vulva
Vagina

40
Q

Microscopically, WSN epithelium is thickened with marked ____, ____, ___

A

Spongiosis, acanthosis, parakeratosis

41
Q

Differential Diagnosis of WSN

A 
HBID
LICHEN PLANUS
LICHENOID DRUG REACTION
LE
CHEEK CHEWING
CANDIDIASIS
42
Q

Hereditary Benign Intraepithelial Dyskeratosis (HBID) is AKA:

A

Witkop’s disease

43
Q

It is an autosomal dominant disease (4q35) which occurs on first year of life. It includes conjunctiva. In oral lesion, it is a soft, asymptomatic, white folds and plaques of spongy mucosa (buccal, labial mucosa, and labial commissures, lateral surface of tongue(except dorsum), floor of mouth, gingiva, palate) . It does not disappear when stretched. May also result to photophobia and blindess

A

HBID

44
Q

It is also known as Darier’s disease or Darier-white disease

A

Follicular Keratosis

45
Q

All except 1 of the hereditary white lesion condition is not an autosomal dominant condition

A

Leukoedema

46
Q

It is a desmosomal defect and dysfunction which alters epithelial cell adhesion (ATP 2A2). + abnormalities in calcium pump.

A

Follicular Keratosis

47
Q

What hereditary condition in which vitamin A analogs or retinoid are used? Because others has no treatment

A

Follicular keratosis

48
Q

It is a white lesion that is related to chronic rubbing or friction against an oral mucosal surface.

A

Focal ( frictional ) hyperkeratosis

49
Q

Focal hyperkeratosis has no malignant potentials

A

True

50
Q

It is caused by snuff dipping

A

White lesion associated with smokeless tobacco

51
Q

White lesion that may cause changes in taste, accelerated periodontal disease, dental abrasion and it may also lead to malignancy

A

White lesions associated with smokeless tobacco

52
Q

It is a carcinogen component of smokeless tobacco or snuff

A

Nitrosonornicotine

53
Q

White lesions associated with smokeless tobacco are usually located at _____

A

Mucobuccal fold of the mandible in incisor or molar region/ mandibular vestibular mucosa surrounding tobacco (snuff dipper’s pouch)

54
Q

This is a common tobacco-related form of keratosis. Associated with pipe and cigar especially those that are reverse smokers

A

Nicotine stomatitis

55
Q

White changes and red dots that are usually found in the palate. It has increased risk of malignant transformation for reverse smokers

A

Nicotine stomatitis

56
Q

The red dots in the palate of a patient with nicotine stomatitis represent ____

A

Inflamm of minor salivary glands

57
Q

Histologic features of this case are :

epithelial hyperplasia and hyperkeratosis
Inflammatory change in minor salivary glands
Squamous metaplasia of excretory duct

A

Nicotine stomatitis

58
Q

This white reactive lesion is almost exclusively seen in patient with HIV

A

Hairy leukoplakia

59
Q

The most favored site of this lesion is in the lateral aspect of tongue and often bilateral

A

Hairy leukoplakia

+sometimes involves ventral surface

60
Q

Give 3 differential diagnosis for hairy leukoplakia:

A 
Idiopathic leukoplakia
Frictional hyper keratosis ( tongue chewing )
Leukoplakia assoc with tobacco use
Lichen planus
LE
Hyperplastic candidiasis
61
Q

Treatment for hairy leukoplakia

A

None

But for cosmetic reasons: acyclovir, ganciclovir, famciclovir, tretinoin, and podophyllum may be given

62
Q

It is a filiform papillary overgrowth on the dorsal surface of the tongue of variable color

A

Hairy tongue

63
Q

T or F

Hairy tongue has a tendency to become malignant and has not treatment

A

False

64
Q

It is a chemical burn or a reaction to a component of toothpaste

A

Dentifrice-associated slough

65
Q

Microscopic examination of this lesion shows presence of elongated filiform papillae over the dorsum

A

Hairy tongue

66
Q

Geographic tongue is also known as

A

Erythema migrans

Benign migratory glossitis

67
Q

It has an unknown etiology but stress can be one of the factors as well as psoriasis.

A

Geographic tongue

68
Q

T or F (2 statements)

Geographic tongue is more prevalent in smokers.
Patients with this case experience irritation or tenderness upon consumption of spicy foods and alcoholic beverages.

A

1st statement is false

2nd statement is true

69
Q

It is characterized by presence of atrophic patches surrpunded by elevated keratotic margins

A

Geographic tongue

70
Q

D/D of geographic tongue

A

Candidiasis
Leukoplakia
Lichen planus
LE

71
Q

T or f

Geographic tongue is benign, asymptomatic, and self-limiting.

A

T

72
Q

Treatment for symptomatic geographic tongue

A 
Mouth rinse  (sodium bicarbonate in water)
Topical steroids ( those than contains antifungal agents)
Reassure px that it is benign to reduce anxiety
73
Q

What form of lichen planus is characterized by numerous interlacing white keratotic lines or striae ( Wickham’s striae). It is usually asymptomatic and commonly occurs in the buccal mucosa

A

Reticular form

74
Q

Form of lichen planus that has an increased tendency to transform into carcinoma

A

Erosive form

75
Q

Form pf lichen planus where it resembles leukoplakia clinically. Primary sites are dorsum of tongue and buccal mucosa

A

Plaque for,

76
Q

Form of lichen planus where it commonly occurs on attached gingiva. Patient commonly complains burning, sensotivity, and generalized discomfort

A

Erythematous form (atrophic)

77
Q

This form of lichen planus has ulceration in the central area.

A

Erosive for,

78
Q

A rarely encountered form of lichen planus and is usually seen in buccal mucosa (posterior and inferiors areas)

A

Bullae variant

79
Q

What form of lichen planus is painful?

A

Erosive form

Ocassionally erythematous

80
Q

Autoimmune disease involving both humoral and cell mediated arms of immune system

A

Lupus erythematosus

81
Q

What part of the oral cavity does DLE commonly occurs?

A

Buccal mucosa, gingiva, and vermilion

82
Q

D/D of LE

A

Lichen Planus

83
Q

D/D of erythematous gingival lupus erythematosus

A

Mucous membrane pemphigoid
Erythematous lichen planus
Erythematous candidiasis
Contact hypersensitivity

Oral pathology (7 decks)

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