ISBAR Lesion handover Flashcards
(43 cards)
a diffuse, grayish-white, opalescent appearance on the oral mucosa, particularly the buccal (cheek) mucosa. It’s usually asymptomatic and considered a normal variant of the oral mucosa, more frequently seen in Black individuals. The lesions are often bilateral and symmetric, appearing as a filmy, grayish-white opacity that doesn’t rub off
Red flags for red lesions
Mnemonic: RED FLAGS (Rapid change, Extreme symptoms, Duration, Features, Location, Associated symptoms, Growth, Size)
My Approach to Red Lesions:
See & Describe: Note shape, size, color, borders, surface, elevation, and distribution.
Ask & Listen: Get onset, evolution, symptoms, triggers, history (personal/family/social), and any systemic issues.
Spot RED FLAGS: Does anything in the history or exam fit the mnemonic?
Document: Record findings and photos.
Refer Urgently If: High suspicion for cancer (ABCDEs, rapid growth, ulceration), severe symptoms/functional impact, blistering/bleeding, unclear diagnosis, persistent/recurrent issues, systemic signs, or in immunocompromised individuals.
Communicate Clearly: Concise history, precise lesion description, highlight RED FLAGS, share photos, state referral reason and urgency.
pigmented lesion
High-Risk Oral Potentially Malignant Disorders (OPMDs) Summary
Left lateral border of the tongue showing thin homogeneous white plaque (black arrows) with ulceration (white arrow)
Candidiasis vs keratin accumulation: A) Candidiasis of the soft and posterior hard palate presenting as white pseudomembranes. B) Coated tongue not associated with oral candidiasis.
A) Morsicatio buccarum on the left buccal mucosa. B) Benign alveolar ridge keratosis of the inferior right retromolar trigone.
Oral lichen planus: Reticular white striae along with regions of erythema on the right buccal mucosa.
Differential diagnosis: A) Superficial mucosal sloughing.
B) Squamous papilloma on the left dorsolateral tongue. benign, wart-like growth. It’s characterized by a verrucous or cauliflower-like surface with finger-like projections. The lesion is usually white or pink, depending on the level of keratinization, and is often found on the dorsal surface of the tongue.
Malignant and premalignant oral leukoplakia and erythroleukoplakia: A) Thin, homogeneous leukoplakia of the right lateroventral tongue. B) Erythroleukoplakia of the left lateral aspect of the tongue.
Proliferative leukoplakia shown as multifocal homogeneous white plaques involving (A) the lower anterior gingiva and lower labial mucosa and (B) the upper anterior gingiva and upper labial mucosa
white lesion tx
Symptomatic traumatic ulceration of the left mid-ventral tongue associated with a sharp left lower molar. The ulcer has flat edges and is surrounded by an area of frictional keratosis. The ulcer was soft on palpation.
Minor aphthous ulceration of the lower right labial mucosa with typical erythematous hallow and yellow base
Left lateral tongue squamous cell carcinoma with irregular margins, heterogeneous appearance and raised, rolled edges. The cancer was palpably firm and indurated, unlike normal tongue tissue.
Left buccal/retromolar trigone squamous cell carcinoma. The lesion had characteristic rolled edges with irregular margins and likely invasion of the posterior mandible, as the lower left molar was mobile. The lesion was initially attributed to cheek biting, which resulted in a delay in referral for several months.
Right floor of mouth squamous cell carcinoma crossing the midline with heterogeneous appearance and irregular margins. The lesion was firm and nodular on palpation.
Early-stage right tongue squamous cell carcinoma in a female patient who did not smoke who presented with a six-week history of a slightly sore right tongue and persistent ulcer. The cancer had irregular margins and heterogeneous appearance and was referred early by her general practitioner.
Lower right lip squamous cell carcinoma presenting as a persistent ulceration with crusting. Note the presence of adjacent sun-related actinic changes across the vermilion zone and border.
The alternating red atrophic areas surrounded by the white raised hyperkeratotic areas typical of geographic tongue
Linear frictional keratosis of the right buccal mucosa corresponding to the occlusal plane where the upper and lower dentition meet
Figure 10. Oral pseudomembranous candidosis of the palate
Figure 11. Denture-associated erythematous stomatitis of the upper palate and alveolus with a papillary appearance anteriorly. The outline of the mucosal change corresponds to the fitting surface of the upper maxillary denture.
