oral lesions Flashcards
(26 cards)
are oral lesions local or systemic
both
why is diagnosing and treat oral lesions of the mouth + gums challenging?
wide variety of diseases that can present
cancer of the oral cavity is associated with….
ulcers or masses that do not heal
tongue + lip cancers are associated with…
exophytic (outward growth) or ulcerative lesions
what accounts for 80% of squamous cell carcinoma of the head + neck
tobacco + ETOH use
what is the common name for recurrent aphthous stomatitis (RAS)
canker sores
what are the sx of recurrent aphthous stomatitis (RAS)
painful, shallow, round/oval, ulcers with grayish base
heal in 10-14 days - more severe can last 6wks
2-4 outbreaks a year
etiology of recurrent aphthous stomatitis (RAS)
celiac dz IBD crohns dz antimetabolite use (methotrexate for RA) dec in mucosal thickening vit b12, folic acid, iron deficiency neutropenia of any cause
tx of recurrent aphthous stomatitis (RAS)
symptomatic
topical corticosteroids (flucinonide, triamcinoline)
topical analgesics applied 2-4x/day
chemical cautery w silver nitrate or sulfuric acid
intralesional or oral glucocorticosteroids for recalcitrant lesions or severe dz
colchicine, dapson (aczone), pentoxifylline (bronchodilator + immunomodulator)
interferon alpha, levamisole
thalidomide in hIV pts - recurrent after cessation of therapy - category X, only rx through special distribution program
risk factors for recurrent aphthous stomatitis
smoking cessation familial tendency trauma (dental cleaning) hormonal factors (luteal phase of cycle- progesterone falls) emotional stress food or drug hypersensitivity HIV
is recurrent aphthous stomatitis infectious
no - not contagious or sexually transmitted
when is recurrent aphthous stomatitis common
children + adolescence
what is bechets disease
neutrophilic inflammatory disorder that causes small vessel vasculitis
presentation of bechets disease
recurrent oral + genital ulcerations + uveitis (triad)
most cases initially start as oral
tx of bechets disease
lesions heal spontaneously (1-3 weeks) colchicine topical anesthetics topical/intralesional corticosteroids systemic glucocorticoids thalidomide dapsone
diagnosis of bechets disease
recurrent oral ulcers (3x+ in 12 mo) + 2 of the following:
recurrent genital lesions
eye lesions
skin lesions
positive pathergy test- minor trauma lead to development of ulcers
**don’t have to be at the same time
what is complex aphthosis
recurrent large oral ulcers in conjunction w genital ulcers in absence of other bechet’s criteria
what is oral leukoplakia
benign reactive process
precancerous lesions
white patches/plaques on oral mucosa- looks like thrush but does not scrape off
hyperplasia of squamous epithelium
can be progressive (20% of pts)
occur in trauma-prone regions (cheek, dorsum of tongue) where mucosa is normally thicker, show less dysplasia
thin areas of mucosa (ventral tongue, retromolar triangle) show more dysplasia
how is leukoplakia diagnosed
biopsy - esp w hx of tobacco + other risk factors
how is leukoplakia treated
chemoprevention (recent interest)
oral retinoids
oral hairy leukoplakia
separate from oral leukoplakia
not premalignant
EBV associated
almost entirely in HIV pts
young children w primary HSV 1 diagnosis may also present with…
fever
LAD
drooling
decreased oral intake
oral candidiasis presentation
white plaques on buccal mucosa, palate or tongue
erythema w.o plaques in denture wearers
beefy, red tongue
angular chelitis
diagnosis of oral candidiasis
clinical white plaques usually scrape off fungal cx KOH prep refractory thrush should warrant HIV testing
