Exam 1 Flashcards

1
Q

Bulla

A

A circumscribed, elevated lesion that is more than 5 mm in diameter
Usually contains serous fluid, and looks like a blister

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2
Q

Lobule

A

A segment or lobe that is part of a whole
These lobes sometimes appear fused together

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3
Q

Macule

A

An area that is usually distinguished by a color different from that of the surrounding tissue
It is flat and does not protrude above the surface of the normal tissue
A freckle is an example of a macule

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4
Q

Nodule

A

A palpable solid lesion up to 1 cm in diameter found in soft tissue
Can occur above, level with, or beneath the skin surface

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5
Q

papule

A

A small, circumscribed lesion usually less than 1 cm in diameter
It is elevated or protrudes above the surface of normal surrounding tissue

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6
Q

pedunculated

A

Attached by a stemlike or stalklike base similar to that of a mushroom

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7
Q

pustules

A

Variously sized circumscribed elevations containing pus

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8
Q

sessile

A

Describes the base of a lesion that is flat or broad instead of stemlike

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9
Q

Vesicle

A

A small, elevated lesion less than 1 cm in diameter that contains serous fluid

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10
Q

erythema

A

abnormal redness

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11
Q

erythroplakia

A

Appears as a smooth red patch or granular, red, velvety patch
Can NOT be rubbed off or diagnosed as a specific disease

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12
Q

pallor

A

paleness

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13
Q

leukoplakia

A

White patch or plaque-like lesion
Can NOT be rubbed off or diagnosed as a specific disease

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14
Q

corrugated

A

wrinkled

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15
Q

papillary

A

Small finger-like projections or elevations found in clusters

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16
Q

verrucose

A

Warty, often with a rough surface

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17
Q

coalescence

A

The process by which parts of a whole join together, or fuse, to make one

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18
Q

Diffuse

A

Describes a lesion with borders that are not well defined, making it impossible to detect the exact parameters of the lesion

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19
Q

well circumscribed

A

Used to describe a lesion with borders that are specifically defined and in which one can clearly see the exact margins and extent

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20
Q

multilocular

A

Describes a lesion that extends beyond the confines of one distinct area
Defined as many lobes or parts that are somewhat fused together
A multilocular radiolucency is sometimes described as resembling soap bubbles

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21
Q

uniocular

A

Having one compartment or unit that is well defined or outlined as in a simple radicular cyst

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22
Q

fordyce granules

A

Clusters of ectopic sebaceous glands
Appear as yellow lobules in clusters
Commonly observed on vermilion border of lips and buccal mucosa
No treatment
More than 80% of adults over 20 years old have

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23
Q

torus palatinus

A

An exophytic growth of normal compact bone
Observed clinically in midline of hard palate
Inherited, gradual formation
More common in women
May take on various shapes and sizes, may be lobulated, and is covered by normal soft tissue
Treatment
None, unless they interfere with speech, swallowing, or a prosthetic appliance
(an example of exostosis)

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24
Q

mandibular tori

A

Outgrowths of dense bone found on the lingual aspect of the mandible in the area of the premolars above the mylohyoid ridge
Usually bilateral
Often lobulated or nodular
Can appear fused together
Have no predilection for either sex
No treatment unless they interfere with fabrication and placement of a prosthodontic appliance

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25
Q

melanin pigmentation

A

The pigment that gives color to skin, eyes, hair, mucosa, and gingiva
Most commonly observed in dark-skinned individuals

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26
Q

lingual varicosities

A

Clinical appearance
Red-to-purple enlarged vessels or clusters
Usually observed on the ventral and lateral surfaces of the tongue
Most commonly observed in individuals older than 60 years

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27
Q

linea alba

A

A “white line” extends anteroposteriorly on the buccal mucosa along the occlusal plane
May be bilateral
May be more prominent in patients who have a clenching or bruxing habit

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28
Q

leukodema

A

A generalized opalescence on the buccal mucosa
Most commonly observed in black adults
If the mucosa is stretched, the opalescence becomes less prominent
No treatment
Up to 90% of cases are observed in black adults.

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29
Q

Median Rhomboid Glossitis (Central Papillary Atrophy)

A

Flat or slightly raised oval or rectangular erythematous area in center of tongue
May be associated with a chronic infection with Candida albicans
No treatment necessary, but antifungal treatment may be used

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30
Q

Erythema Migrans/Benign Migratory Glossitis(Geographic Tongue)

A

Erythematous patches surrounded by a white or yellow border
Diffuse areas devoid of filiform papillae
Distinct presence of fungiform papillae
Ectopic can occur on other muciosal tissues
No treatment needed

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31
Q

Fissured Tongue(Scrotal Tongue)

A

Clinical appearance
The dorsal surface of the tongue appears to have deep fissures or grooves
Cause: Unknown
Probably involves genetic factors
Seen in about 5% of the population

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32
Q

white hairy tongue

A

Clinical appearance
Elongated filiform papillae are white
Result of either an increase in keratin production or a decrease in normal desquamation
Home care
Direct the patient to brush the tongue gently with a toothbrush to remove debris

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33
Q

Black hairy tongue

A

Clinical appearance
Papillae are brown-to-black because of chromogenic bacteria
Contributing factors
Tobacco
Foods
Hydrogen peroxide
Alcohol
Chemical rinses
Home care
Direct the patient to brush the tongue gently with a toothbrush to remove debris

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34
Q

inflammation

A

Nonspecific response that allows the body to eliminate injurious agents, contain injuries, and heal defects
Extent and duration of injury → determine extent and duration of inflammatory response

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35
Q

local inflammation

A

one area

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36
Q

systemic inflammation

A

whole body

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37
Q

classic signs of inflammation localized

A

Redness
Heat
Swelling
Pain
Loss of normal tissue function

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38
Q

classic signs of inflammation systemic

A

Fever
Leukocytosis
Elevated C-reactive protein (CRP)
Lymphadenopathy

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39
Q

pyrogens

A

a fever over 98.6

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40
Q

Leukocytosis

A

Increase in #WBCs (10,000-30,000)
Normal= 4,000-10,000

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41
Q

Elevated C-reactive protein

A

Protein produced in liver

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42
Q

Lymphadenopathy

A

Enlarged lymph nodes
Results from hyperplasia & hypertrophy of lymphocytes

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43
Q

hyperplasia

A

enlargement of tissue from increased NUMBER of cells

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44
Q

Hypertrophy

A

enlargement of tissue from increased SIZE of its cells

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45
Q

inflammation sequence

A

-injury to tissue
-constriction of microcirculation
-dilatation of microcirculation
-increased permeability
-exudate leaves
-increased blood viscosity
-decreased blood flow
-margination and pavementing of WBC
-WBC’s enter tissue
-WBC’s ingest foreign material

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46
Q

hyperplasia

A

An increase in the number of cells, often in response to chronic irritation or abrasion
May return to normal if the insult subsides, or may persist after removal of the irritant

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47
Q

hypertrophy

A

An increase in the size of cells
May be seen in cardiac muscle as a response to hypertension

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48
Q

Atrophy

A

A decrease in size or function of a cell, tissue, organ, or entire body

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49
Q

Regeneration

A

The process by which injured tissue is replaced with tissue identical to that present before the injury

50
Q

Repair

A

The restoration of damaged or diseased tissues

51
Q

Healing by primary intention

A

Healing of an injury in which there is little loss of tissue
The margins are close together and very little granulation tissue forms
Oral mucosa is less prone to scar formation

52
Q

Healing by secondary

A

The edges of the injury cannot be joined during healing
A large clot forms, resulting in increased granulation tissue
May result in excess scar tissue: A keloid

53
Q

Healing by tertiary intention

A

Delaying surgical tissue repair until infection is resolved
An injured area may become infected, especially with puncture wounds

In some situations, an infected injury is left open until infection is controlled

54
Q

attrition

A

tooth to tooth wear

55
Q

Bruxism

A

Grinding and clenching teeth for nonfunctional purposes

56
Q

abrasion

A

Pathologic wearing away of tooth structure that results from a repetitive mechanical habit

Most frequently seen as a notching on root surfaces with gingival recession

57
Q

abfraction

A

Appearance: Typically appears as wedge-shaped lesions at the cervical areas of teeth

58
Q

erosion

A

Loss of tooth structure as
a result of chemicals, without bacterial involvement

59
Q

meth abuse

A

Rapid destruction of teeth as a result of:
Methamphetamine acid content
Decreased salivary flow
Cravings for high-sugar beverages
Lack of oral hygiene

60
Q

Peripheral Giant Cell Granuloma

A

A lesion that contains many multinucleated giant cells, well-vascularized connective tissue, RBCs, and chronic inflammatory cells
Reactive lesion
Clinical appearance resembles that of pyogenic granuloma
Treatment: Surgical excision

61
Q

external resorption

A

Nonreversible resorption of the tooth structure, beginning at the outside of the tooth
Causes
Inflammation
Pressure
Reimplantation
Idiopathic

62
Q

internal resorption

A

tooth or root resorption: Resorption often associated with an inflammatory response in the pulp or an idiopathic reason
Appearance
Clinically: A pinkish area in the crown resulting from the vascular, inflamed connective tissue
Radiographically: Radiolucent

63
Q

Immunity

A

the body has memory to fight infection

64
Q

B-cell lymphocytes

A

Develops from stem cells in bone marrow
Matures in lymphoid tissue
lymph nodes & tonsillar tissue
B-cells travel to injury site when stimulated by antigen
Two main types:
Plasma cell - produce specific antibody needed to fight antigen
B-memory cell- retains memory of previous antigen

65
Q

B-Cell Lymphocytes: Plasma Cells

A

Plasma cells produce antibodies (immunoglobins)
Carried in blood serum

66
Q

IgA

A

Found in Saliva, breast milk, stomach secretions

67
Q

IgE

A

Lung, Skin & cells of mucous membranes

68
Q

IgG

A

Most circulating antibodies

69
Q

what makes up the immune complex

A

antibodies + antigen

70
Q

difference between inflammation and immunity

A

immunity has memory

71
Q

type 1 hypersensitivity

A

Hay fever
Asthma
Anaphylaxis

72
Q

type 2 hypersensitivity

A

cytotoxic type
Autoimmune hemolytic anemia

73
Q

Type 3 hypersensitivity

A

immune complex type
Autoimmune diseases

74
Q

Type 4 hypersensitivity

A

cell-mediated type
Granulomatous disease
Tuberculosis

75
Q

Allergic/anaphylactic

A

(rapid onset) (IgA)

76
Q

Cytotoxic type

A

(IgG/IgM)

77
Q

Immune complex

A

(autoimmune disorders)

78
Q

Delayed/cell-mediated type

A

(dermatitis, delayed reaction)

79
Q

aphthous ulcers

A

Painful oral ulcers with an unclear cause
Reported incidence ranges from 5% to 56%
Trauma is the most common precipitating factor
May be caused by emotional stress or certain foods

May be associated with certain systemic diseases

80
Q

3 types of aphthous ulcers

A

Minor
Major
Herpetiform

81
Q

Minor Aphthous Ulcers

A

Most common
Discrete, round to oval, <1 cm, yellowish-white surface surrounded by erythema
Movable mucosa of oral cavity, gingiva
1-2 day prodromal period with burning or soreness
Single or multiple lesions
Heal in 7-10 days

82
Q

Major Aphthous Ulcers

A

> 1cm, deeper, last longer
Painful, often in posterior portion of mouth
Diagnosis: biopsy…
May take several weeks
to heal and result in
scarring
(Sutton’s disease,
periadenitis mucosa
necrotica recurrens)

83
Q

Urticaria

A

Hives
Swelling and itching of the skin
Localized areas of vascular permeability
Acute self-limited episodes, or chronic or recurrent forms

84
Q

Erythema Multiforme

A

Acute self-limiting disease affecting the skin and mucous membranes
Target lesions on the skin that appear in concentric rings of erythema and normal skin color
Oral lesions are either ulcers or erythmatous areas

85
Q

triggering factors of erythema multiforme

A

herpes simplex, tuberculosis, histoplasmosis, malignant tumors, and certain drugs

86
Q

treatment of erythema multiforme

A

Topical or systemic corticosteroids, antiviral medication

87
Q

Stevens-Johnson syndrome

A

Most severe form of erythema multiform
Lesions are more serious and painful
Encrusted and bloody lips, genital mucosa and mucosa of the eyes could be involved

88
Q

Lichen Planus

A

Effects the skin and/or oral mucosa
Wickham striae
Small, papular, white nodule most commonly seen on buccal mucosa
Diagnosis: clinical and histological appearance
Treatment: topical corticosteroids, oral hygiene

89
Q

Reiter Syndrome (Reactive Arthritis)

A

Triad of arthritis, urethritis, conjunctivitis
Aphthous like ulcers, erythematous lesions, and geographic tongue like lesions
Diagnosis- clinical signs and symptoms
Treatment- nonsteroidal antiinflammatory drugs such as aspirin

90
Q

Sjogren Syndrome

A

Decrease in saliva and tears of salivary and lacrimal glands
Xerostomia
Cellular AND humoral immunity
Lips cracked and dry, loss of papillae on dorsal tongue surface, increased risk of caries, periodontal disease, and oral candidiasis

91
Q

diagnosis and management of sjogren syndrome

A

Diagnosis is made when two of three components are present
Xerostomia
Measurement of salivary flow and biopsy can help
Keratoconjunctivitis sicca
Confirmed by eye examination
Rheumatoid arthritis
For most patients, the course of the disease is chronic and benign, but these patients are at risk for the development of other, more serious diseases

92
Q

Treated symptomatically
Nonsteroidal antiinflammatory

A

agents for arthritis
May need corticosteroids and immunosuppressive drugs for severe cases

93
Q

Treated symptomatically Saliva substitutes for xerostomia

A

Humidifier, sugarless gum, or lozenges
Pilocarpine

94
Q

Treated symptomatically Glasses and/or artificial tears

A

to protect eyes
Good oral hygiene
Fluoride
Frequent re-care appointments

95
Q

Systemic Lupus Erythematosus

A

Acute and chronic
“Butterfly” rash on the nose, white erosive lesions (Ibsen)
Arthritis and arthralgia
Dx: antinuclear antibodies in serum,
multiorgan involvement

96
Q

Pemphigus Vulgaris

A

Severe progressive autoimmune disease
Mucosal ulcerations, fragile vesicles or bullae
Dx: biopsy and microscopic examinations
Tx: high doses of corticosteroids, immunosuppressive drugs

97
Q

Nikolsky sign
of pemphigus vulgaris

A

Rubbing with a finger can produce a bulla

98
Q

Bullous Pemphigoid

A

Mostly in elderly populations
Detectable autoantibodies
Oral lesions less common than in cicatrical pemphigoid
Tx: systemic corticosteroids, NSAIDS

99
Q

Tuberculosis

A

Infectious chronic granulomatous disease
Caused by organism Mycobacterium Tuberculosis
Primary infection is in lungs:
inhaled droplets undergo Phagocytosis by macrophages but are resistant to destruction and
multiply in the macrophages
Travel by blood stream to kidney, liver, and lymph nodes.

100
Q

Infectious Diseases

A

Oral cavity contains numerous microorganisms that make up the normal oral flora
400-500

101
Q

types of infectious diseases

A

Bacterial, fungal and viral infections are most common
Protozoan and helminthic infections - rare

102
Q

Opportunistic Infections

A

affect the oral flora so that organisms that are usually
nonpathogenic
are able to
cause disease

103
Q

Syphilis

A

Treponema pallidum “Spirochete”

Acquired & congenital
Direct contact or infected blood

3 stages:
primary, secondary and tertiary

Primary “chancre” lesion= HIGHLY infectious!

104
Q

syphilis secondary lesion

A

“mucous patch”-
multiple painless, grayish white plaques covering ulcerated mucosa
Most infectious stage occurs 6 weeks after primary lesion appear
Oral lesions
Treatment –penicillin G
Can undergo spontaneous remission
Can recur for months/years

105
Q

syphilis tertiary

A

Tertiary syphilis occurs in infected persons…
Many years after nontreatment of secondary syphilis
Localized lesion termed “gumma” and is noninfectious
Lesion appears as a firm mass that eventually becomes an ulcer
Very destructive and can lead to palatal perforation

106
Q

Congenital Syphilis

A

Transmitted to the offspring by an infected mother.
Developmental disorders in child
Characteristics of congenital syphilis:
high palatal areasaddle nosedeafnessMulberry molarsHutchinson’s incisors

107
Q

“Acute” Necrotizing Ulcerative Gingivitis

A

Painful erythematous gingivitis
Tissue sloughing = pseudomembrane appearance
Accompanied by
Fever, cervical lymph node enlargement
lymphadenopathy
Necrosis of the interdental papillae
blunted appearance
Most likely caused by both a fusiform bacillus and spirochete
Associated with decreased resistance to infection.
very foul odor and metallic taste

108
Q

Periocoronitis

A

Inflammation of the mucosa around the crown of a partially erupted, impacted tooth.
Most common site –mandibular 3rd molars
Bacteria is proliferating in pocket
Trauma, impaction of food, compromised host factors associated with increased risk of Periocoronitis

109
Q

Herpes: oral & genital

A

Viral
Primary herpes (I)
Acute or primary herpetic gingivostomatitis

Painful, erythematous & swollen gingiva & multiple tiny vesicles on the perioral skin, vermilion border of the lips & oral mucosa
Vesicles progress to form ulcers

110
Q

oral herpes VIRAL INFECTIONS

A

Vesicles progress to form ulcers
Systemic symptoms such as fever, malaise & cervical lymphadenopathy

Occurs most commonly in children between 6 months & 6 years.

Disease is self-limited & heals spontaneously in 1 to 2 weeks

Kissing is a common way of spreading

111
Q

Secondary herpes or recurrent herpes simplex infection

A

Virus persist in a latent state, usually in the nerve tissue of trigeminal ganglion
~1/3 to ½ of the pop. has this
Cold sore, fever blister
Intraoral lesions found:
~Attached or bound down tissue

112
Q

Herpetic Whitlow

A

A primary or recurrent infection
>eye infections also

113
Q

shingles

A

Herpes zoster
Varicella-zoster virus
Chickenpox virus (age 10-14)
Vaccines available
Childhood & adults over 50
Occurs unilateral
(see Text: 4-30)
painful eruption of vesicles along the distribution of a sensory nerve
Decrease of CMI (cell- mediated immunity)

114
Q

Coxsackie type A

A

Herpangina
Aphthous Pharyngitis
Lesions on soft palate along with fever, malaise, sore throat, and difficulty swallowing (dysphagia)
Resolves in less than a week without treatment.
Hand Foot & Mouth

115
Q

Verruca vulgaris

A

Human wart virus
white, papillary, exophytic lesion
looks like a papilloma
Papillary oral lesion
Transmitted by direct contact
(skin to oral mucosa and lips)
Autoinoculation occurs through finger sucking or fingernail biting
Benign tumor of squamous epithelium

116
Q

Epstein- Barr Virusherpes Virus 4

A

Epstein-Barr virus has been implicated in several diseases that occur in the oral region including:
Infectious mononucleosis
Nasopharyngeal carcinoma
Burkitt’s lymphoma
Hairy leukoplakia

117
Q

Epstein-Barr VirusInfectious Mononucleosis

A

Sore throat
Fever
Generalized lymphadenopathy
Enlarged spleen
Malaise, and fatigue
Oral –palatal petechiae
Diagnosis: blood test
Usually benign, self-limited disease (4-6 weeks)

118
Q

HIV INFECTION: Signs/symptoms/consequences

A

Wasting Syndrome
Neurological disease
Secondary infections or conditions
(opportunistic/fatal)
Pneumocystis carinii pneumonia
Tuberculosis
Non-Hodgkin’s lymphoma
Kaposi’s sarcoma
Viewed on next slide…

119
Q

secondary infections of HIV

A

hairy leukoplakia (Epstein Barr virus)
herpes zoster
tuberculosis
oral candidiasis

120
Q

List some Viruses or viral conditions more likely to be present in the oral cavity…

A

Human papillomavirus (warts)
Herpes simplex virus (herpetic stomatitis)
Varicella virus (Shingles)
Epstein Barr (Hairy leukoplakia)
Oral ulcerations
Salivary gland enlargement
Idiopathic thrombocytopenic purpura (spontaneous bleeding)

121
Q

Types of candidiasis

A

Pseudomembranous
Acute atrophic
Chronic atrophic
(denture stomatitis)
Chronic hyperplastic
angular cheilitis
Treatment - antifungal medication, e.g.. Nystatin