Mucous Membrane Disorders

Question 1

Cheilitis common in

Answer 1

AIDS

SE of PI

Question 2

ACD of lip

Answer 2

Vermillion MC
f>M
Fragrance and nickel MC

Question 3

Angular cheilitis

Answer 3

Elderly who wear dentures

Decreased vertical dimension of face

Question 4

Plasma cell cheilitis

Answer 4

Sharply defined, dark red infiltrated plaque with a lacquer like glaze
Reactive

Question 5

Plasmacanthoma

Answer 5

Verrucous tumor along the angles
Spectrum with plasma cell cheilitis
C albicans found
May involve perianal, periumbilical, inguinal, and toe webs

Question 6

Drug induced ulcer of the lip

Answer 6

Painful, well defined ulceration of lower lip that heals with Med withdrawal
Phenylbutazone, chlorpromazine, phenobarbital, methyldopa, thiazides diuretics

Question 7

Oral crohns

Answer 7

Metallic dysgeusia, gingival bleeding, diffuse oral swelling, focal mucosal hypertrophy and fissuring (cobblestoning), ulceration, polyploid lesions, indurated lower lip fissure, angular cheilitis, gran cheilitis, pyo veg

Oral involvement in 10-20% of crohns, esp males with early onset dz

Question 8

Cutaneous findings in crohns

Answer 8

PG (more UC), EN, polyarteritis nodosa, pellagra, pernicious anemia, acrodrmatitis like rxn, urticaria, necrotizing vasculitis

Question 9

Pyostomatitis vegetans

Answer 9

UC > crohns
Sclerosing cholangitis
Dense aggregates of neuts and eos
May see annular plaques of axilla, groin, scalp (pyodermatitis vegetans)

Question 10

Melkerson rosenthal associations

Answer 10

Mega colon, otosclerosis, craniopharyngioma, odontogenic infection
Neuropathic origin?

Question 11

Nicotine stomatitis

Answer 11

Hot beverages, heavy smokers, most severe with pipes

Question 12

Fissured tongue (lingua plicata)

Answer 12

MRos, downs, PC, pemphigus vegetans, cowden

Question 13

Geographic tongue

Answer 13

MC isolated
May be a manifestation of atopy or PSO, AIDS, lithium
Red patches with a white border, serpiginous
No sx, occasional glossodynia
No tx or retin a solution

Question 14

Black hairy tongue

Answer 14

Benign hyperplasia of filliform papilla

Smoking, ab, psychotropic meds, candida

Question 15

Hunter or moeller glossitis

Answer 15

Smooth tongue with b12 def

Question 16

Eruptive lingual papillitis

Answer 16

Mean age 3, seasonal
Difficulty eating, fever, intense salivation
Hypertrophic of fungiform papillae
Involution in 2-15 days, avg week

Question 17

Eosinophilic ulcer of the oral mucosa

Answer 17

Ulcer with indurated and elevated border with pseudomembrane
Posterior tongue
Post traumatic
Self limited
Cd30 cells in recurrent multifocal cases

Question 18

Caviar tongue

Answer 18

Elastic degeneration

Phleboliths and thrombophlebitis may complicate

Question 19

Epdermization of the lip

Answer 19

Smooth leukokeratosis of lower lip

Question 20

Proliferative verrucous leukoplakia

Answer 20

F MC
70% become SCC (palate and gingiva especially)
Some associated with HPV 16, SCC RF not present

Question 21

Acquired dyskeratotic leukoplakia

Answer 21

White plaques of gingiva, lips, palate

Unique finding of dyskeratotic cells of prickle layer

Question 22

White sponge nevus

Answer 22

Acanthosis, vacuolated prickle cells, acidophilus condensations in cyto of keratinocytes (aggregated tonofilaments)
Buccal mucosa MC, no extramucosal
Progression stops at puberty
Hpv16 found in some
Tx = TCN

Question 23

Ephelides

Answer 23

Lower lip
Darken with sun

Oral melanotic macules - young women, don’t darken with sun, acanthosis and basilar melanin on bx

Melanoacanthoma - proliferation of keratinocytes and melanocytes, young black pts on buccal mucosa, reactive, 40% spont resolve

Question 24

Oral melanoma

Answer 24

Palate MC

Less than 5% survival at 5 yrs

Question 25

Oral pigmentation

Answer 25

Amiodaquine, chloraquine, OCP, phenothiazines, quinacrine, quinidine, thallium, azt

Question 26

Osseous choristoma of tongue

Answer 26

Nodule on dorsal tongue containing mature lamellar bone

Question 27

Peripheral ameloblastoma

Answer 27

Gingiva of lower jaw in M in his 50s Growing pink sessile mass 19% recurrence after excision BCC simulated histologically

Question 28

Trumpeters wart

Answer 28

Firm hyperkeratosis nodule on upper lip of trumpet player

Question 29

Epulis

Answer 29

Benign lesion of gingiva, reactive Giant cell epulis bluish red on gingiva, induced by dental implants, Cherubism, resemble GCT of the tendon sheath

Question 30

Oral PG

Answer 30

MC gingiva

Question 31

Granuloma fissuratum

Answer 31

Circumscribed, firm, whitish on the labioalveolar fold | Chronic irritation like poorly fitting dentures

Question 32

Angina bullosa haemorrhagica

Answer 32

Sudden blood blisters on oral mucosa No associated dz May be recurrent

Question 33

Multiple mucoceles

Answer 33

GVHD Rupture of salivary glands with extravasated of sialomucin Parotid duct cyst- musicians who play wind instruments, opposite the upper 2nd molar on buccal mucosa Dermoid cyst - may occur on mouth floor

Question 34

Trench mouth RF

Answer 34

Poor dental hygiene and nutrition, smoking, ectasy, immunosuppressive Noma- fusospirillary gangrenous stomatitis in kids, triggered by measles

Question 35

Acatalasemia (takaharas dz)

Answer 35

Catalase def in liver, m., BM, rbcs and skin Progressive mouth gangrene H202 added to blood turns blackish brown and doesn't foam Tx is extraction of diseased teeth and ab

Question 36

PFAPA

Answer 36

Tonsillectomy cures

Question 37

Oral hsv

Answer 37

Affects keratinzed mucosa of palate, gingiva, tongue that's is attached to bone (herpangina and aphthous ulcers affect nonattached mucosa)

Question 38

Aphthous stomatitis

Answer 38

White with a ring of hyperemia Buccal or labial mucosa > edge of tongue> soft palate Affect nonkeratinized mucosa not attached to bone Rarely confluent (vs herpes) MC lesion of oral mucosa Maslow 5 min before meals held in mouth, kaolin can be added Fluocinonide in orabase Colchicine, dapsone

Question 39

Major aphthous ulcer (Suttons dz)

Answer 39

HIV associated

Question 40

Behcets

Answer 40

Dirty gray base with a bright red halo Ocular lesions start with periorbital pain and photophobia, may see conjunctivitis and hypopyon, both eyes eventually involved CNS resemble MS Thrombophlebitis, thrombosis of the superior vena cava Polyarthritis MC LCV or neutrophilic vascular rxn on path Sucralafate- colchicine- dapsone-thalidomide-mtx