Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS5 oral disease > oral pigmentation > Flashcards

oral pigmentation Flashcards

1
Q

describe melanocyte histological appearance (3)

A
  • spaced dendritic cells in basal layer
  • small with clear cytoplasm
  • S100 stain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe melasma (what, cause)

A
  • disorder with patchy discolouration of the skin, often of the face
  • sun exposure, genetics, hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does physiological pigmentation present? (3)

A
  • bilateral, diffuse
  • brown (but can range)
  • often on gingiva and BM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe smoker’s melanosis (5)

A
  • ~1/5 of smokers, dose dependent
  • post-inflammatory change
  • dark brown/black
  • gingiva, hard palate, BM
  • often resolves on smoking cessation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does Addison’s disease affect melanin production?

A
  • primary adrenal insufficiency (cortisol/aldosterone) causing increased ACTH
  • ACTH also promotes melanogenesis
    (also mood disturbances, nausea, vomiting, weight loss)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe Peutz-Jegher syndrome (what, s/s)

A
  • mutations in STK11
  • mucocutaneous pigmented macules with intestinal polyposis (small intestine, rarely undergo malignant transformation)
  • flat brown/black spots - lower lip, BM, tongue, palate +/- hands/feet
  • histologically similar to melanotic macule
  • often fade post-puberty
  • polyps may grow large - obstruct bowel, pain
  • increased risk of cancer development
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

common sites for pigmented macules of Peutz-Jegher syndrome (5)

A
  • lower lip
  • BM
  • tongue
  • palate
  • sometimes hands and feet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe Laugier Hunziker syndrome (3)

A
  • similar features to Peutz-Jegher syndrome but no intestinal polyps
  • multiple acquired pigmented macules of lips and oral mucosa
  • females 2x more
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe LEOPARD syndrome

A
  • different types, AD RAS gene mutations
    Lentigines (pigmented macules)
    ECG abnormality
    Ocular hypertelorism
    Pulmonary stenosis
    Abnormal genitalia
    Retarded growth
    Deafness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe melanotic macules (4)

A
  • well-defined, flat brown lesions
  • increase in melanin production
  • lips, gingivae, BM, palate
  • no tx needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

common intraoral areas for melanotic macules (4)

A
  • lips
  • gingivae
  • BM
  • palate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe lentigo (what, types)

A
  • well-defined pigmented lesion of skin
  • increase in benign melanocytes with associated increase in melanin pigment
  • photo/actinic lentigo = associated with sun exposure and photodamage, older pts on face and hands
  • lentigo simplex = non-sunexposed skin, children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the common name for lentigines and ephelides?

A

freckles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe naevus of Ota (3)

A
  • benign melanosis due to failed migration of melanocytes from neural crest
  • females
  • hyperpigmentation of ophthalmic and maxillary branches of CV (white of eye, face)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe naevus of Ito (3)

A
  • benign melanosis due to failed migration of melanocytes from neural crest
  • females
  • hyperpigmentation affecting posterior supraclavicular and lateral brachial cutaneous nerves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the difference between naevus of Ota vs naevus of Ito?

A

hyperpigmentation affecting:
- CV1, CV2 = Ota
- posterior supraclavicular and lateral brachial = Ito

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the common name for melanocytic naevi?

A

moles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe melanocytic naevi (what, where, appearance)

A
  • benign neoplasm of melanocytes
  • mostly acquired
  • skin or intraoral - hard palate, buccal mucosa, gingiva
  • well-circumscribed, dark with smooth or cerebriform surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

common intraoral sites of melanocytic naevi (3)

A
  • hard palate
  • BM
  • gingivae
20
Q

what are the 3 phases of melanocytic naevi and how do their clinical appearances differ?

A

1a = early/junctional = neoplastic melanocytes in epithelium and proliferate - flat
1b = compound stage = migrate deeper and sit between epithelium and CT - flat
2 = late/intradermal stage = melanocytes within connective tissue - dome-shaped

21
Q

how may a late-stage melanocytic naevus appear in biopsy? (2)

A
  • purple rounded islands of melanocytes in connective tissue
  • more spindled appearance towards the bottom of the lesion (should not change throughout life)
22
Q

risk factors for malignant melanoma (4)

A
  • genetic mutations
  • ethnicity
  • UV sun damage
  • type 1 and 2 skin (pale, red hair, blue eyes, freckling, prone to sun-related damage)
23
Q

describe malignant melanoma (what, appearance)

A
  • de novo or progress from melanocytic naevi
  • flat or nodular lesions with suspicious signs and progression
  • rare intraorally but very poor prognosis - palate, upper alveolar ridge
24
Q

what does ABCDE mean when looking at suspicious pigmented lesions?

A

Asymmetry
Borders (irregular)
Colour variation
Diameter >6mm
Evolution or erythema

25
Q

intraoral sites for malignant melanoma (2)

A
  • palate
  • upper alveolar ridge
26
Q

describe how malignant melanomas develop (4)

A
  • atypical melanocytes within epidermis
  • melanocytic dysplasia = increased number, pleomorphic, clusters, NO INVASION
  • radial growth phase = horizontal and superficially, little invasion into CT
  • vertical growth phase = through basement membrane into connective tissue
27
Q

what is Breslow thickness?

A

measures how far a melanoma has penetrated into the skin in mm

28
Q

histology of malignant melanoma (3)

A
  • large clusters of S100+ melanocytes in epithelium with invasion into connective tissue
  • brown pigment
  • atypical melanocytes = dark nucleus, halo of cytoplasm
29
Q

what is the most common oral pigmented lesion?

A

amalgam tattoo

30
Q

describe an amalgam tattoo (what, appearance, histology)

A
  • fragments of amalgam embedded into oral mucosa
  • often traumatic aetiology
  • particles distributed along collagen fibres and vessels, disperse over time = irregular outline
  • <5mm usually, grey-blue
  • histology = tiny and some larger amalgam particles associated with multinucleated giant cells
31
Q

describe intraoral heavy metal pigmentation and give some metals that cause this

A
  • mercury, lead, bismuth, platinum
  • blue-black deposits in gingival sulcus (GCF) from systemic exposure
32
Q

describe black hairy tongue (what, aetiology)

A
  • accumulation of keratin of filiform papillae of tongue dorsum midline
  • picks up stain by pigment-producing bacteria, food or smoking
  • uncertain aetiology but more common in heavy smokers, poor OH, drugs, radiotherapy
33
Q

black hairy tongue management (2)

A
  • smoking cessation
  • good OH and tongue scraping
34
Q

which types of UV light have the highest and lowest energy?

A

C highest
A lowest
(all ionising)

35
Q

UVA radiation effects (4)

A

(low energy)
- short-lived tan
- drying (indirect DNA damage)
- photoaging (skin atrophy, wrinkles)
- carcinoma

36
Q

UVB radiation effects (3)

A
  • deeper, longer-lasting tan
  • deep skin damage (direct DNA damage)
  • main cause of sunburn and skin cancer
37
Q

UVC radiation effects

A

(highest energy)
- no effect as it interacts with ozone layer and does not reach the ground

38
Q

what are the effects of sunlight generally? (6)

A
  • sunburn
  • photoaging
  • photosensitivity
  • actinic keratosis
  • carcinogenesis (lip SCC)
  • tan
39
Q

describe photoaging (what, sites, histology)

A
  • premature aging due to UV exposure
  • leathery nodular skin
  • face, ears, lips, hands, forearms
  • patchy hyperpigmentation (sunspots)
  • thickened dermis, distorted vasculature, solar elastosis
40
Q

describe photosensitivity

A

immune reaction triggered by sunlight

41
Q

describe actinic keratosis (what, presentation, demographic)

A
  • premalignant lesion
  • white to brown in colour
  • irregular scaly plaques, in clusters in UV-exposed skin
  • > 40yo with long history of UV exposure
42
Q

actinic keratosis histology (3)

A
  • increased thickness of epidermis and parakeratin layer
  • some degree of dysplasia/nuclear changes
  • superficial CT shows UV damage (collagen, elastic fibres) = pale bluish band of fibrous CT (solar elastosis)
43
Q

describe lip SCC (risk factors, preceded by)

A
  • risks/demographic:
    – males
    – outdoor/rural occupations
    – renal transplants and immunosuppression
    – pipe and cigarette smoking
  • often preceded by actinic cheilitis
  • fewer in dark-skinned races
44
Q

what is actinic cheilitis? (2)

A
  • precancerous condition from prolonged sun exposure
  • rough, scaly, discoloured patches on lips (esp lower lip)
45
Q

what is a tan?

A

skin response to UV light causing melanin accumulation to protect against UV light

BDS5 oral disease (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions