Mouth Flashcards
Mucosal Lesions
Oral Lichen planus Leukoplakia Erythroplakia Oral SCC Melanoma Fordyce's Spots
Stomatitis
Oral Candidiasis Pseudomembranous stomatitis Recurrent Aphthous Stomatitis Herpetic Gingivostomatitis Oral Erythema Multiforme Chancre
Oral Edema
Angioedema (Quincke’s edema)
Other Oral Findings
Palatal or Mandibular Torus Hemangioma Varicosities Papilloma Lipoma
Salivary Glands
Sialadenitis
Sjogren’s syndrome
Xerostomia
Oral Lichen planus
Etiology: unknown
Non-erosive lesion: painless, vary from lace-like white patches/papules/streaks on buccal mucosa to erosions on gingival margin
Erosive form: can erupt into violet papules with white lines/spots, on genitalia, lower back, ankles, pruritus
Chronic can increase risk of oral CA
Leukoplakia
Etiology: trauma, dentures, tobacco use, oral sepsis, syphilis, AIDS, vitamin deficiency, alcoholism, endocrine disturbances
Precancerous hyperplasia of squamous epithelium;
white patches or plaque on oral mucosa cannot be rubbed off
SSX: located on tongue, mandibular alveolar ridge, buccal mucosa
forms nonpalpable, faintly translucent white areas to thick, fissured, papillomatous indurated lesions
looks like “flaking white paint”
PE: lesion cannot be wiped away with gauze
check for cervical LA
DX: biopsy for definitive diagnosis
DDX: Candidiasis and aspirin burn (can be wiped away with gauze)
Erythroplakia
Red macule or plaque with well-demarcated edges with soft texture
Often on floor of mouth, tongue, or palate
Etiology: Unknown, type of epithelial dysplasia, pre-cancerous
DX: Biopsy
Risk factors: smoking, alcohol
Oral SCC
Risk factors: alcohol & smoking
Most on floor of mouth or lateral & ventral surfaces of tongue
SSX: appear as erythroplakia or leukoplakia
exophytic or ulcerated, both rea indurated with rolled border
metastatic mass (non tender) in neck may be first symptom
DX: Biopsy any persistent papules, plaques, erosions or ulcers
Melanoma
pigmented lesions with concerning signs: ABCD, lesions will not blanch
DDX: Melanosis - symmetric lesions in individuals with dark skin
oral melanotic macules - symmetric, stable, sharply delimited dark macules on lips or oral mucosa
Fordyce’s Spots
Benign neoplasms from sebaceous glands
Most common 20-30 yrs M=F
SSX: asymptomatic, multiple, white to yellow, 1-2mm papules, often occurring confluent cluster, granules do not wipe off
DDX: Candida albicans - wipes off
Stomatitis -
Inflammation of oral tissue
Etiology: strep, candida, syphilis, TB, measles, HIV, etc. deficiencies: vit. B & C, iron
mechanical trauma: poor fitting dentures
alcohol, tobacco mercury poisoning
Oral Candidiasis
“Thrush” Common oral fungal infection
Risk factors: denture-wearing, DM, antibiotics, chemo, HIV, infants
SSX: Lesion, slightly raised soft white plaques, easily wipe off, causing bleeding
DX: confirmed with KOH prep - recurrent warrants immune status eval
Recurrent Aphthous Stomatitis
aphthae = canker sore
Acute, painful, recurring, necrotizing ulcerations of oral mucosa
Etiology: Provocations (exact cause unknown)
trauma, food allergies, vit. deficiencies, stress
associated with celiac disease & IBS
SSX: Painful lesions, occasional prodromal burning/tingling,
ulcers are shallow, round with grayish base, red border
occur on non-keratinized, moveable mucosa
DDX: Secondary herpetic ulceration - h/o of vesicles preceding the ulcers, a location on periosteum-bound mucosa (gingival, hard palate) & crops of lesions
Trauma, pemphigus vulgaris & cicatricial pemphigoid
Systemic disorders: crohn’s disease, neutropenia & spue
Herpetic Gingivostomatitis
HSV-1 infection “Cold sores”
Painful eruptions of unmovable oral mucosa & vermilion border
SSX: prodrome of pain, burning, tingling, fever, malaise, LA -> eruption of multiple interoral vesicular lesions & erosions, erythematous base, crusting, self limiting 1-2wks
Lab: Tzank smear, direct immunofluorescence smear, or viral culture
DDX: aphthous stomatitis, erythema multiforme, drug eruptions, epmphigus
