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DG2013 - Oral Medicine Day 1 > Red, White and Pigmented Lesions > Flashcards

Red, White and Pigmented Lesions Flashcards

1
Q

Haemangioma:
1. Describe the appearance
2. How do they respond to pressure?
3. What is the treatment for this?
4. If treatment is done, where should it be carried out and why?

A
  1. Red or blue painless lesion usually on lips or tongue
  2. When pressure is applied, they will blanch
  3. Treatment - monitor and potential surgical removal or laser removal at patient’s request
  4. Surgical removal needs to be done in a hospital as there is risk of severe haemorrhage
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2
Q

Kaposi’s Sarcoma:
1. Which 2 infections is this associated with?
2. How does it present?
3. How is it treated?
4. What type of cancer is this?

A
  1. HIV and Herpes 8
  2. Red, purple/brown tumours on palate or gingiva
  3. Treated - in HIV patients the HAART drugs can help to slow the progression of Kaposi’s sarcoma
  4. Sarcoma of blood vessels
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3
Q

Erythroplakia:
1. How does it present clinically?
2. What does this pose an increased risk of?
3. Why is this unique of all oral lesions?
4. How is this treated?

A
  1. Bright red velvety patches, mainly of soft palate, FOM or buccal mucosa
  2. Increased risk of malignant transformation
  3. This is the most serious of all oral premalignant lesions
  4. Treatment - Removal of risk factors e.g. smoking or alcohol and BIOPSY needed to treat further
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4
Q

Fungal - Acute and chronic erythematous candidosis:
Acute:
1. List 2 associations

Chronic:
1. What is this caused by and give the term

A

Acute:
1. Associated with antibiotic use and HIV

Chronic:
1. Caused by wearing dentures too often - Denture stomatitis

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5
Q

Black hairy tongue:
List 4 associations:

What mouthwash can also cause discolouration of the tongue - give chemical name also.
-How long is the recommended use for this?

A
  1. Soft diet
  2. Smoking
  3. Poor OH
  4. Dry mouth

Corsodyl mouthwash - chlorhexidine
-Use for no longer than 2 weeks

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6
Q
  1. What substance in the body cause most endogenous lesions?
  2. List 2 reasons why this occurs:
A
  1. Melanin
  2. a) Over production of melanin by melanocytes (e.g. inflammation)
    b) Increased release of melanin from cell death of keratinocytes (e.g. smoking)
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7
Q

Idiopathic melanotic macules:
1. How do they present?
2. Are they serious?
3. How are they treated?

A
  1. Flat, singular brown spots
  2. Common benign lesions
  3. Recommended to remove as could potentially be melanoma
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8
Q

Melanotic Naevus:
1. How does this present clinically?
2. Are there any symptoms?
3. How is this treated

A
  1. Blue-black benign lesions on palate or on gingiva
  2. Asymptomatic
  3. Removed by excision to exclude possibility of melanoma
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9
Q

Racial pigmentation - what is this?

A

Brown pigmentation mainly affecting the gingiva - seen mainly in black and ethnic minorities

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10
Q

Smokers Melanosis:
1. How does this present?
2. What causes this?

A
  1. Presents as a brown/black pigmentation on the gingiva, buccal mucosa, palate and larynx
  2. The toxic chemicals in smoke bind to melanin in epithelial cells and travel to tissue surface - causes the pigmentation
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11
Q

Puetz-Jegher Syndrome:
1. How does this present?
2. What causes this?
3. How is this treated?
4. Does this need to be referred and why?

A
  1. GI polyps and melanotic spots on lips and oral mucosa
  2. Caused by genetic factors - very rare
  3. Excision to treat
  4. Yes, needs to be referred for cancer screening due to high risk of colon and breast cancer
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12
Q

Addison’s (adreno-cortical insufficiency):
1. What is it?
2. How does it present clinically?
3. How is this treated?
4. What is the test for Addison’s disease?

A
  1. Destruction of adrenal glands - adrenocortical
  2. Brown pigmentation of gingiva and oral cavity
  3. Treatment with replacement therapy of corticosteroids
  4. Synacthen test - measurement of serum electrolytes
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13
Q

Albrights Syndrome:
1. What is this?
2. How does this present clinically?

A
  1. A genetic bone disorder and skin pigmentation
  2. ‘Cafe au lait’ pigmentation on the skin
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14
Q

Sarcoidosis:
1. What is this?
2. How does this present clinically?

A
  1. Exaggerated immune response - body attacks its own tissues and organs
  2. Hyperpigmented lip lesions, multiple granulomas
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15
Q

What is drug-induced endogenous oral pigmentation caused by?

A

Chloroquine

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16
Q

Leukaemia: How does this present in the oral cavity?

A

Haemorrhagic areas/patches commonly along the gingiva

17
Q

Malignant Melanoma:
1. How does this present?
2. List 4 signs of malignancy
3. How is this treated?

A
  1. Heavily pigmented macule affecting the palate or maxillary gingiva
  2. -Rapid increase in size
    -Change in colour
    -Ulceration
    -Pain
  3. Treatment - radical excision
18
Q

Frictional keratosis:
1. List 3 things this is caused by?
2. How does this present clinically?
3. How is this treated?

A
  1. Sharp teeth, cheek biting, dentures
  2. Pale white patches which become more dense and whiter
  3. Treat - remove stimuli and biopsy white patches
18
Q

Frictional keratosis:
1. List 3 things this is caused by?
2. How does this present clinically?
3. How is this treated?

A
  1. Sharp teeth, cheek biting, dentures
  2. Pale white patches which become more dense and whiter
  3. Treat - remove stimuli and biopsy white patches
19
Q

Nicotinic stomatitis:
1. What causes this?
2. How does this present clinically?
3. How is this managed?

A
  1. Long-term cigar/pipe smoking
  2. Hyperkeratosis - mostly effects the palate
  3. Management - encourage patient to stop smoking
20
Q

Actinic Cheilitis: (Sailors/farmer’s lip)
1. What causes this?
2. How does it present? - give 3 features
3. Is this potentially malignant?

A
  1. Caused by long-term exposure to sunlight
  2. White lesions, red/erosive/ulcerative lesions, scaley hardened skin around the lips
  3. Yes! potential for malignancy
21
Q

Lichen planus:
1. How does this present?
2. What causes this?
3. Does it require treatment?

A
  1. White interlacing lines usually bilateral on buccal mucosa, gingiva and tongue
  2. Cause is unknown
  3. Usually left untreated
22
Q

Lichenoid Reactions:
1. What causes this?
2. How does it present?
3. How is it treated?

A
  1. Caused by a reaction to a drug or material
  2. Similar presentation to lichen planus - white interlacing lines
  3. Treatment - remove the cause
23
Q

Leukoplakia:
1. What is this?
2. What causes this?

A
  1. A white patch on mucous membrane that does not rub off
  2. Cannot be associated with anything other than the use of TOBACCO
24
Q

Idiopathic leukoplakia:
1. What causes this?
2. How does it present clinically?
3. Where in the oral cavity would you expect to see this?

A
  1. Cause is unknown
  2. Tough and raised plaques and can have red, nodular lesions - BE SUSPICIOUS - HIGH RISK MALIGNANCY
  3. Seen on FOM, tongue, posterior regions in oral cavity
25
Q

Candidal Leukoplakia:
1. How does this present?
2. List 3 steps taken to treat

A
  1. Appears bilaterally in commissure on the cheek and can have speckled background
  2. Treat with antifungals, smoking cessation, biopsy
26
Q

Syphilitic Leukoplakia:
1. How does this present?
2. What causes this?
3. How is this diagnosed?

A
  1. White lesions on dorsum of tongue - usually spares the margins
  2. Normally complication of tertiary syphilis
  3. Diagnosed by serology - biopsy is essential - HIGH MALIGNANCY POTENTIAL
27
Q

Hairy Leukoplakia:
1. What causes this?
2. How does it present clinically?
3. How is this diagnosed?

A
  1. Link to Epstein-Barr virus and HIV patients
  2. Soft, usually painless white plaques with corrugated surface - typically on lateral boarder of the tongue
  3. Biopsy essential for diagnosis - indicates rapid progression of HIV into AIDS
28
Q

Speckled Leukoplakia:
1. What is this seen as a combination of or transition between?
2. How does it present?
3. Which has a higher rate of malignant change, speckled or non-speckled?

A
  1. Combination or transition between leukoplakia and erythroplakia
  2. Presents as white and red speckled patch
  3. Speckled leukoplakia has higher rate of malignant change
29
Q

White Sponge Naevus:
1. How does this present?
2. Other than oral cavity, where can this present?
3. How is it diagnosed and how serious is it?

A
  1. White shaggy or wrinkled surface on mucosa
  2. Can affect anus or vagina
  3. Needs biopsy to confirm diagnosis
    -Reassure patient condition is BENIGN
30
Q

Oral submucous fibrosis:
1. How does this present?
2. What can cause this?
3. How is this treated?

A
  1. Tight vertical lines in buccal mucosa which can restrict oral opening and mucosa is pale
  2. Can be caused by genetic factors and betel nut chewing
  3. Treated - remove nuts, jaw exercises, corticosteroids
31
Q

Keratinising carcinomas can appear as and in what?

A

Keratinising carcinomas can appear as or in ORAL WHITE LESION

DG2013 - Oral Medicine Day 1 (6 decks)

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