Oral Medicine Multi Disciplinary Case Flashcards
What is the appearance of verruca vulgaris
What is it?
Any questions to ask?
Upside down V shape, exophytic
- the common wart that can present on the skin or the oral cavity
- benign and proliferation of the squamous epithelium
Do they have any lesions elsewhere on their body?
What is HPV?
Human papilloma virus
Most common STI
Common features of low risk HPV?
Verruca vulgaris lesions
- warts in oral cavity
- exophytic upside down V surface
Condyloma acuminatum
- genital wart presentations
- exophytic and cauliflower like
Squamous cell papillomas
- exophytic hairy like pedunculated lesions
When is incisional biopsy indicated?
When there is indication the lesion may be malignant or the lesion is very large
When is excisional biopsy indicated?
Discrete lesions, smaller in size with no suspicious features
How might one anaesthetise a tissue for a biopsy? How ensure sufficiently numb?
Infiltrations at 3/4 points around the periphery of the lesion
- blanching of tissues
- test area with sharp probe and reassure pt feel pressure not pain
How should biopsy material be transported to lab?
Secured in a pathology pot immersed in formalin
- ensure labelled correctly with pt details and specimen sampled
Give some ways haemostasis can be achieved after biopsy
Suturing
- not applicable on palate
- sutures or can suture a pack over lesion
Electrocautery
- better for lesions where sutures not applicable
Post op instructions after biopsy?
Expect some pain, swelling or bruising
- take OTC analgesia before LA wears off
Soft diet for first couple of days
Keep area clean with chlorhexadine
May bleed minimally for up to 72 hours
- apply gauze and slight pressure with finger
Avoid strenuous exercise for 24H
Avoid alcohol and smoking for 24H
Histopathological of carcinoma acuminatum?
Acanthosis
Parakeratosis
Tissue organised in papillae
Koilocytes in epithelium
- indicative of viral infection
- irregular, bi or multinucleated cells
No dysplasia or malignancy
