Common Lesions - part I

Question 1

nevus

Answer 1

“mole” - benign melanocytic lesion

Question 2

a decrease in pigmentation occurs as the nevi does what?

Answer 2

progress from junctional to compound to intradermal

Question 3

growth of nevus

Answer 3

junctional –> compound –> intradermal/intramucosal

Question 4

ephelides

Answer 4

“freckles” - brown pigmentation that develops following sun exposure

Question 5

ephelides is more common in who?

Answer 5

children and fair skinned individuals

Question 6

lentigo is what type of lesion?

Answer 6

benign melanocytic

Question 7

lentigo

Answer 7

macular (flat), no change in color intensity with exposure to UV light

Question 8

number of lentigo increases in who with age?

Answer 8

in Caucasians

Question 9

seborrheic keratosis

Answer 9

benign skin lesion with a “stuck on” appearance

Question 10

what does seborrheic keratosis look like?

Answer 10

“dropped on candlewax”

Question 11

dermatosis papulosa nigra is a variant of what?

Answer 11

seborrheic keratosis

Question 12

dermatosis papulosa nigra occurs in what percent of the black population?

Answer 12

~30%

Question 13

actinic keratosis is a precursor lesions for what?

Answer 13

cutaneous squamous cell carcinoma

Question 14

actinic keratosis has what type of texture?

Answer 14

“sandpaper” texture

Question 15

tx for actinic keratosis

Answer 15

1. surgical excision
2. topical, immune-activating agents such as Aldara
3. use of sun blocking agents
4. limit sun exposure

Question 16

telangectatic capillaries

Answer 16

prominent vessels

Question 17

telangectatic capillaries may be an indication of what?

Answer 17

sun damage

Question 18

when does sebaceous hyperplasia occur?

Answer 18

usually over 40 y.o.

Question 19

where does sebaceous hyperplasia occur?

Answer 19

often seen on forehead

Question 20

what happens when sebaceous hyperplasia achieve 1-2 mm in size?

Answer 20

minimal to no further growth

Question 21

what is the central umbilication often seen in pts with sebaceous hyperplasia?

Answer 21

sebaceous duct

Question 22

what is the most common cancer in humans?

Answer 22

basal cell carcinoma

Question 23

clinical features of basal cell carcinoma

Answer 23

1. “mask” area
2. rolled borders
3. umbilicated center
4. telangiectasia

Question 24

what is often associated with basal cell carcinoma?

Answer 24

nevoid basal cell carcinoma syndrome

Question 25

fordyce granules

Answer 25

ectopic sebaceous glands

Question 26

fordyce granules can be seen anywhere in the mouth but what is the most common location?

Answer 26

buccal mucosa

Question 27

T/F: fordyce granules can appear on the lips

Answer 27

true

Question 28

what is angular cheilitis associated with?

Answer 28

loss of vertical dimension

Question 29

what causes angular cheilitis?

Answer 29

candida

Question 30

some angular cheilitis may be co-infected with what?

Answer 30

candida and staph

Question 31

tx of angular cheilitis if for external use only

Answer 31

can use topical application of combo antifungal/corticosteroid cream

Question 32

what is the most common site for recurrent HSV-1?

Answer 32

vermilion border and/or adjacent skin of lips

Question 33

melanotic macule

Answer 33

focal increase in melanin

Question 34

melanotic macule can also occur as reactive melanosis in response to what?

Answer 34

local trauma

Question 35

mucocele

Answer 35

focal deposition of mucous

Question 36

what causes mucocele?

Answer 36

damage to associated minor salivary gland duct

Question 37

tx of mucocele

Answer 37

conservative... remove extravasated mucous and associated minor salivary glands

Question 38

leukoedema

Answer 38

intracellular edema

Question 39

where is linea alba found?

Answer 39

along occlusal plane

Question 40

morsicatio buccarum, linguarum, labiorum

Answer 40

cheek, tongue, lip nibbling/chewing

Question 41

what causes morsicatio buccarum, linguarum, labiorum?

Answer 41

shredded keratin at site(s) accessible to teeth

Question 42

fibroma

Answer 42

benign collection of dense fibrous CT

Question 43

tx of fibroma

Answer 43

conservative removal

Question 44

what causes lichen planus?

Answer 44

it's an immunologically mediated process

Question 45

clinical features of lichen planus

Answer 45

1. "striae" or lacy | 2. doesn't wipe off

Question 46

lichenoid mucositis

Answer 46

descriptive term which could apply to several conditions

Question 47

what does maxillary torus comprise of?

Answer 47

dense, vital lamellar bone

Question 48

where can inflammatory papillary hyperplasia be found?

Answer 48

1. under sub-optimally fitting RPD or full denture | 2. high palatal vault

Question 49

what might inflammatory papillary hyperplasia reflect?

Answer 49

constant wear

Question 50

tx of inflammatory papillary hyperplasia

Answer 50

1. conservative excision | 2. new denture

Question 51

nicotine stomatitis

Answer 51

inflammed minor salivary glands of the palate with hyperkeratosis around the orifices

Question 52

nicotine stomatitis is commonly seen in who?

Answer 52

1. pipe smokers | 2. long-term use of hot beverages

Question 53

what causes black hairy tongue?

Answer 53

overgrowth of chromogenic bacteria and filiform papillae

Question 54

fissured tongue

Answer 54

multiple grooves in tongue

Question 55

fissured tongue pts often also have what?

Answer 55

geographic tongue

Question 56

pts with geographic tongues may be sensitive to what?

Answer 56

spicy or acidic food when lesions are present

Question 57

where does ectopic geographic tongue occur?

Answer 57

in locations other than dorsal or lateral tongue

Question 58

foliate papilla is part of what?

Answer 58

Waldeyer's ring

Question 59

foliate papilla

Answer 59

vertical lines at posterior lateral tongue often see lymphoid tissue in that area as well

Question 60

mandibular tori

Answer 60

vital lamellar bone

Question 61

where are mandibular tori commonly seen?

Answer 61

lingual

Question 62

amalgam tattoo

Answer 62

silver in amalgam stains reticulin fibers in associated CT

Question 63

if you're unsure if it's an amalgam tattoo, what should you do?

Answer 63

may need to excise to rule out melanoma

Question 64

parulis

Answer 64

intraoral opening of sinus track

Question 65

what must be ruled out to dx parulis?

Answer 65

odontogenic source of infection

Question 66

where is pericoronitis most commonly found?

Answer 66

in mandibular 3rd molars

Question 67

what causes pericoronitis?

Answer 67

food, etc. gets caught b/w overlying soft tissue (operculum) and crown of partially impacted tooth

Question 68

tx of pericoronitis

Answer 68

remove offending tooth and opposing 3rd molar

Question 69

what might be done to initially tx pericoronitis?

Answer 69

decrease local inflammation with rinses then surgery