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Flashcards in orl Deck (153)
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1
Q
A

herpetiform aphtous ulcers

numourous ulcers, sizes 1-3 mm, not very deep,invisible scars,

location:ventral side of the tongue (fig. 47) - buccal mucosa - floor of the mouth

treatment: corticosteroids (15-40
mg/day for a period of 7 days
and
tetracyclines

2
Q
A

herpetiform aphtous ulcers

3
Q
A

minus aphtae

4
Q
A

SOLAR CHEILITIS ​(actinic cheilitis)

5
Q
A

nicotinic stomatitis

6
Q
A

verroucous lekoplakia

7
Q
A

actinic chelitis

8
Q
A

idiopathic leukoplakia non homo/ erythroleukoplakia

9
Q
A

minor aphtae

female population and young adults

burning sensations, paresthesia or local hyperesthesia 24-48 hours prior

round or oval shape and less than 1 cm

very painful, covered by a white-yellowish necrotic tissue/ well circumscribed, with a specific erythematous hallo

Their most common locations are: - labial mucosa - the margins and ventral surface of the tongue - buccal mucosa - vestibule of the mouth - floor of the mouth

Treatment: anti-inflammatory agents kenlog

oral antiseptic solutions LISTERINE®

antibiotic with tetracyline >>>> achromycine

analgesic>>>xylocaine

mandatory to eliminate all local sources of irritation and a thorough oral hygiene will be instituted, together with complete avoidance of spicy, acid or irritating foods and allergenic agents

10
Q
A

sloar chelitis /actinic chelitis

premalignant esion / mostly on lower lips ,/ workers / white population

early stage we see mild keratinisation that causes the disappearance of the line between the edge of vermillion and the surrounding skin, then becomes chronic and white patches appear , deffused margins,swallon crustand lips loss their elassticity.

complementary tests: biopsy and histopathalogical examinatins

treatment: prevenntive: sunscreen and ZINC OXIDE based cream

CRYOTHERAPY (FREZZING STUFF)

11
Q
A

bechet syndrome

white necrotic ulcers covered by serous exudates, oval ulcers, can be supeficial or profoud,bright red margins

frequent location is on: - lips - gingiva - buccal mucosa - tongue

without leaving any scars,

complementary test:Histopathologic examination

serological examinations

One particularity of Behçet disease is the hypersensitivity of the skin to needle sting that manifests as an erythemal-papular reaction, followed by the formation of a sterile pustule.

treatment: minor>>>>>>s topic steroids administration, painkillers and non-steroid anti-inflammatory medication.

major>>>>>>>>>>>immunosupression meds like corticosteroids(levamisol)

12
Q
A

discoid lupus erythematosous

13
Q
A

sloar chelitis or actinic chelitis

14
Q
A

minus aphtae

15
Q
A

WHITE SPONGE NEVUS (​Canon disease)

symetrical lesions ,asymptomatic, white and spongy , on jugal mucosa , lateral of the tongue, labial mucosa, floor of the mouth

Histopathologic examination

no treatment required

16
Q
A

behcet syndrom

17
Q
A

behcet syndrom

18
Q
A

nicotinic stomatitis

19
Q
A

herpetiform aphtous ulcers

20
Q
A

verroucous leukoplakia

21
Q
A

SECOND SYPHILIS

22
Q
A

2ND SYFLIS

23
Q
A

ATrophic glossitis

24
Q
A

major aphtous

unilateral , the lesion is profound and it appears crater shape with irreguar bottom , size 1-5cm -necrotic center,no bleed , painful,dysphagia and dysphonia

**** leaves scar>>>exclude malignency

location: lateral and ventral side of the tongue , buccal, labial , palatin tonsil

*treatment: if its gigantic >> bacidracin tablets

*dexametazone

*systemic steroids hydrocortizon

prednizone

all minor treatments

surgical removal

25
Q
A

nicotinic stomatitis

26
Q
A

actinic chelitis

27
Q
A

SECONDARY SYPHLIS

28
Q
A

frictional hyperplasia

29
Q
A

ertholeukoplakia

30
Q
A

behcet syndrome

31
Q
A

sclerotic glossitis

32
Q
A

discoid lupus erythematosous

33
Q
A
34
Q
A

SECONDARY SYPHILIS

35
Q
A

frictional hyperplasia

36
Q
A

Discoid lupus erythematosus (DLE)

Skin lesions develop on sun-exposure

purplish patches on the skin

specific aspect of “butterfly wings” on the face.

The favoured locations of the lesions are: - buccal mucosa - lower lip - gingival fibre-mucosa - tongue

central atrophic red patch with whitish lines disposed as sunrays.

Complementary examinations: direct immunofluorescence test and histopathologic

Treatment :Oral lesions are treated with topical steroid medication

oral administration of corticosteroids or anti-malaria medication.

37
Q
A

gumma

38
Q
A

gumma

39
Q
A

gumma

40
Q
A

discoid lupus erythematosous

41
Q
A

2NDARY SYPHILIS

42
Q
A

discoid lupus erythematosous

43
Q
A

???? Homogenous leukoplakia !!!!

idiopathic leukoplakia{thickening of the mucosal layer, hyperkeratinization)

etiology:alcohol, candida albikans60%, mecha, chemic, anemia

Location: jugal mucosa , lips, lateral of tongu, retromolar areas , palate

clicical aspect:assymptomatic burning sensationby irritants, keratotic lesions ……>>>> homogenous: white flat patches..>>> less malignancy

Non-homogenous: white, whiteyellow, gray lesions or white red mixed ……… can be nodular or spicky …..more ratio of dysplasia or malignancy…..>>>>types: verrucous leukoplakia {spicky one} , erytholeukoplakia, nodular leukoplakia

treatment: with dysplasia >>>> co2 laser, surgical crayotherapy

without dysplasia>>>>> retinoid compounds , BETA CAROTHEN

44
Q
A

SECONDARY SYPHILIS

45
Q
A

2NDSARYSYPHILIS

46
Q
A

nodular leukoplakia

47
Q
A

TERTIARY SYPHILIS

1/3 OF 1/3 cases of syphilis will develop the third

It is mainly characterized by:

neurological manifestations

cardiovascular lesions

lesions of the skin and mucosa

bone lesions

3 LESIONS

GUMA >>>> HARD PALATE FISTUA

ATROPHIC GLOSITIS

SCLROTIC GLLOSITIS

48
Q
A

discoid lupus erythematosous

49
Q
A
50
Q
A

white sponge nevous

51
Q
A

idiopathic leukoplakia

erythroleukoplakia/ non homogenous

52
Q
A

major aphtous

53
Q
A

erythroleukoplakia

54
Q
A

major aphtus

55
Q
A

verrucous leukoplakia

56
Q
A

minus aphtae

57
Q
A

nicotinic stomatitis

heavy smokers pipe smokers no prosthesis appliance starts with deussed erythema and then epithelium gets hyperkeratinazed and become thick . small red dots are covering the orifficess of the salivary glands////location mainly palatin veil

histopathalogical examination

stopsmoking

58
Q
A

FRICTIONAL HYPERPLASIA ​(​traumatic keratosis)

: lips, lateral margins of tongue, jugal mucosa ​along the occlusion plane of teeth

an isolated, white and thickened patch on the mucosa due to orthodontic appliance , eating with odontholous spaces , cheek biting

no complementary test

no treatment needed

59
Q
A

major aphtus

60
Q
A

primary syphlis

vdrl

tpha

microscopic dark fieldexamination

painless >>>The specific lesion of syphilis is chancre

PENICILIN FOR ALL SYPHLIS STAGES

61
Q
A

PRIMARY SYPHILIS

62
Q
A

major aphus

63
Q
A

PRIMARY SPHILIS

64
Q
A

PRIMARY SYPHILIS

65
Q
A

nodular leukoplakia

66
Q
A

PRIMARY SYPHILIS

67
Q
A

major aphtus

68
Q
A

white sponge nevous

69
Q
A

a dark-red macular eruption -syphilitic rosella, located mainly on the posterior side of the oral cavity

dark field microscopic examination and immunofluorescence examination

TREATMENT PENICILIN

70
Q
A

major aphtus

71
Q
A

2ND SYPHLIS

72
Q
A

frictional hyperplasia

73
Q
A

behcet syndrom

74
Q
A

atrophic form of lichen planus

red, atrophic not ulcerative

loc: gingiva
c. t general stuff

non -specific clinical aspect is desquamated gingivitis”​​(fig. 89) and it interests symmetrically each of the four quarters

The symptoms accompanying this condition are irritation, burns or dryness of the mucosa.

treatment :cyclosporine, coricoid creams,TACROLIMUS

75
Q
A

reticularform of lichen planus

reticular lichen planus

most common tupe of planus

common location: jugal mucosa bilateral , but also on lips tongue , gingiva

clinical aspect: keratotic lesions called wicham straiae (so many)

C.test: histopathalogical test

immunofluorocense tet

treatment: assymptomatic lesion>>no treatment needed

symptomatic lesion>>>> systemic cyclosporine

76
Q
A

reticular lichen planus

most common tupe of planus

common location: jugal mucosa bilateral , but also on lips tongue , gingiva

clinical aspect: keratotic lesions called wicham straiae (so many)

C.test: histopathalogical test

immunofluorocense tet

treatment: assymptomatic lesion>>no treatment needed

symptomatic lesion>>>> systemic cyclosporine

77
Q
A

angular chelitis

is a type of chronic candidiasis

bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts

C.T NO NEED

TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field

antifungal antibiotic therapy

78
Q
A

chronic atrophic candidiasis (prosthesis candidiasis)

LOCATED MAINLY ON THE HARD PALATE

HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia

pain and burning is common

C.T : immunofluorocense examination

treatment: nystatin sol 100.000u/ml 4times a day

amphotericin B suspension 100mg/ml 4 times a day

miconazole gel 2% 4*aday

new prosthetic device , rigorous oral hygiene

remove the prosthetic at nights

79
Q
A

angular chelitis

is a type of chronic candidiasis

bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts

C.T NO NEED

TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field

antifungal antibiotic therapy

80
Q
A

angular chelitis

is a type of chronic candidiasis

bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts

C.T NO NEED

TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field

antifungal antibiotic therapy

81
Q
A

median rhomboid glositis

is a kind of chronic candidiasis

central papillary atrophy of the tongue

clinicalfeatures: first soft red denudated patch located on the median line of the dorsal side of the tongue ,,,,,,,,,,,,,,,,,later it gets hard and lobulated ,,,,,it is - cm oval or rhombic with rounded borders

82
Q
A

median rhomboid glositis

is a kind of chronic candidiasis

central papillary atrophy of the tongue

clinicalfeatures: first soft red denudated patch located on the median line of the dorsal side of the tongue ,,,,,,,,,,,,,,,,,later it gets hard and lobulated ,,,,,it is - cm oval or rhombic with rounded borders

83
Q
A

sclerotic glossitis >>>>>median rhomboid glossitis

median rhomboid glositis

is a kind of chronic candidiasis

central papillary atrophy of the tongue

clinicalfeatures: first soft red denudated patch located on the median line of the dorsal side of the tongue ,,,,,,,,,,,,,,,,,later it gets hard and lobulated ,,,,,it is - cm oval or rhombic with rounded borders

84
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

85
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

86
Q
A

chronic atrophic candidiasis (prosthesis candidiasis)

LOCATED MAINLY ON THE HARD PALATE

HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia

pain and burning is common

C.T : immunofluorocense examination

treatment: nystatin sol 100.000u/ml 4times a day

amphotericin B suspension 100mg/ml 4 times a day

miconazole gel 2% 4*aday

new prosthetic device , rigorous oral hygiene

remove the prosthetic at nights

87
Q
A

chronic atrophic candidiasis (prosthesis candidiasis)

LOCATED MAINLY ON THE HARD PALATE

HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia

pain and burning is common

C.T : immunofluorocense examination

treatment: nystatin sol 100.000u/ml 4times a day

amphotericin B suspension 100mg/ml 4 times a day

miconazole gel 2% 4*aday

new prosthetic device , rigorous oral hygiene

remove the prosthetic at nights

88
Q
A

acute atrophic candidiasis

erythematous or stomatitis following antibiotic therapy

clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )

located mainly on the tongue and hard palate

{depapilation of the tongue is prsent }

C.T: direct microscopic examination , culture media

treatment: topical or systemic anti fungal therapy

89
Q
A
90
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

91
Q
A

hairy tongue

hairy tongue,

heredity, emotional stress, imunodeficiecy

its benign and its dekeratinization of the tongue

Usually the condition is located on the 2/3 dorsal and the lateral sides of the tongue

round ovale , erythematous border with white peripheral zone…….. more importantly it changes its appearance every 12-24 hours

no complementary test

treatmnt: just inform the patient that its a benign situation/ in caseof painful fissures use antifungal and topical steroids

92
Q
A

hairy tongue,

heredity, emotional stress, imunodeficiecy

its benign and its dekeratinization of the tongue

Usually the condition is located on the 2/3 dorsal and the lateral sides of the tongue

round ovale , erythematous border with white peripheral zone…….. more importantly it changes its appearance every 12-24 hours

no complementary test

treatmnt: just inform the patient that its a benign situation/ in caseof painful fissures use antifungal and topical steroids

93
Q
A

hairy tongue

keratin deposit on the tongue (appears in a hypertrophic form )

etiology:severe smoking candida albikans , low immune , poor hygine, long term use of antibiotics, metronidazol, systemic corticosteroids

clinicalaspect : hypertrophic lesion of the tongue in diff colors like white gray, yellow , brown it starts from foramen cecum of the tongue to lateral and anterir side of the tongue

no complementary test

treatment: nystatine if candida, palleteknife in moderate cases, brushing, keratolytic agents like salicilic acid

94
Q
A

hairy tongue

hairy tongue,

heredity, emotional stress, imunodeficiecy

its benign and its dekeratinization of the tongue

Usually the condition is located on the 2/3 dorsal and the lateral sides of the tongue

round ovale , erythematous border with white peripheral zone…….. more importantly it changes its appearance every 12-24 hours

no complementary test

treatmnt: just inform the patient that its a benign situation/ in caseof painful fissures use antifungal and topical steroids

95
Q
A

reticular lichen planus

reticularform of lichen planus

reticular lichen planus

most common tupe of planus

common location: jugal mucosa bilateral , but also on lips tongue , gingiva

clinical aspect: keratotic lesions called wicham straiae (so many)

C.test: histopathalogical test

immunofluorocense tet

treatment: assymptomatic lesion>>no treatment needed

symptomatic lesion>>>> systemic cyclosporine

96
Q
A

reticular form of lichen planus

reticularform of lichen planus

reticular lichen planus

most common tupe of planus

common location: jugal mucosa bilateral , but also on lips tongue , gingiva

clinical aspect: keratotic lesions called wicham straiae (so many)

C.test: histopathalogical test

immunofluorocense tet

treatment: assymptomatic lesion>>no treatment needed

symptomatic lesion>>>> systemic cyclosporine

97
Q
A

reticular form of lichnplanus

reticularform of lichen planus

reticular lichen planus

most common tupe of planus

common location: jugal mucosa bilateral , but also on lips tongue , gingiva

clinical aspect: keratotic lesions called wicham straiae (so many)

C.test: histopathalogical test

immunofluorocense tet

treatment: assymptomatic lesion>>no treatment needed

symptomatic lesion>>>> systemic cyclosporine

98
Q
A

erosive form of lichenplanus

clinical aspect: burning and pain sensation more red than white compare to reticular form , erythematous lesion with some straia but the straia is not as white

retrocomissural (where mandible and maxila meet intraorally)

lower buccal vestibule(buccal mucosa) near the molar >>>> lower means mandible side

comlementary test: histo+ immunofluorosens

treatment

general:cyclosporine , nystatin in candida associated and cortico steroids cream and injection intra lesional

99
Q
A

plaque form lichen planus

similar clinical aspect with leukoplakia,

the hyper-keratotic area can be neat or slightly harsh

. introduced retinoid treatment (Etretinate) with anti-keratinized

It is more frequently found on the ​dorsal part of the tongue and it usually expands in a centrifugal pattern

second jugal mucosa

complementary test : florocense , histopathalogocal

100
Q
A

reticular lichen planus

reticularform of lichen planus

reticular lichen planus

most common tupe of planus

common location: jugal mucosa bilateral , but also on lips tongue , gingiva

clinical aspect: keratotic lesions called wicham straiae (so many)

C.test: histopathalogical test

immunofluorocense tet

treatment: assymptomatic lesion>>no treatment needed

symptomatic lesion>>>> systemic cyclosporine

101
Q
A

reticular form of lichen planus

reticular lichen planus

reticularform of lichen planus

reticular lichen planus

most common tupe of planus

common location: jugal mucosa bilateral , but also on lips tongue , gingiva

clinical aspect: keratotic lesions called wicham straiae (so many)

C.test: histopathalogical test

immunofluorocense tet

treatment: assymptomatic lesion>>no treatment needed

symptomatic lesion>>>> systemic cyclosporine

102
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

103
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

104
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

105
Q
A

acute atrophic candidiasis

erythematous or stomatitis following antibiotic therapy

clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )

located mainly on the tongue and hard palate

{depapilation of the tongue is prsent }

C.T: direct microscopic examination , culture media

treatment: topical or systemic anti fungal therapy

106
Q
A

acute atrophic candidiasis

erythematous or stomatitis following antibiotic therapy

clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )

located mainly on the tongue and hard palate

{depapilation of the tongue is prsent }

C.T: direct microscopic examination , culture media

treatment: topical or systemic anti fungal therapy

107
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dysphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

108
Q
A

major aphtous

109
Q
A

Kaposi’s sarcoma

its an endothelial cells malignancy

4 types:1* classic kaposi’s sarcoma (skin lesion)

2*african kaposi’s sarcoma(skin lesions)

3*aquired kaposi’s sarcoma (skin)

4*EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation

lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.

located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva

C.T is biopsy

treatment: radiotherapy surgery, chemotherapy Co2 laser

110
Q
A

Kaposi’s sarcoma

its an endothelial cells malignancy

4 types: classic kaposi’s sarcoma (skin lesion)

african kaposi’s sarcoma(skin lesions)

aquired kaposi’s sarcoma (skin)

EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation

lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.

located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva

C.T is biopsy

treatment: radiotherapy surgery, chemotherapy Co2 laser

111
Q
A

Kaposi’s sarcoma

its an endothelial cells malignancy

4 types: classic kaposi’s sarcoma (skin lesion)

african kaposi’s sarcoma(skin lesions)

aquired kaposi’s sarcoma (skin)

EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation

lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.

located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva

C.T is biopsy

treatment: radiotherapy surgery, chemotherapy Co2 laser

112
Q
A

Kaposi’s sarcoma

its an endothelial cells malignancy

4 types: classic kaposi’s sarcoma (skin lesion)

african kaposi’s sarcoma(skin lesions)

aquired kaposi’s sarcoma (skin)

EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation

lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.

located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva

C.T is biopsy

treatment: radiotherapy surgery, chemotherapy Co2 laser

113
Q
A

Kaposi’s sarcoma

its an endothelial cells malignancy

4 types: classic kaposi’s sarcoma (skin lesion)

african kaposi’s sarcoma(skin lesions)

aquired kaposi’s sarcoma (skin)

EPIDEMIC KAPOSI’S SARCOMA :OVER 50% of the patients showed oral manifestation

lesion has 3 stages>>> first its assymptomatic erythematous that dont disappear after pressure >>>then it gets bigger and it will turn into red-blue or purple papular lesion>>> and at the advanced stages sarcoma appears purplish,blue nodules that can bleed and its painful.

located on jugal mucosa, dorsal face of the tongue, half of the palate, on the gingiva

C.T is biopsy

treatment: radiotherapy surgery, chemotherapy Co2 laser

114
Q
A

Bullous lichen planus

bulla or vesicles can be from mm tocm

they will burst into painfull erosions located normally on the juggal mucosa near the wisdom tooth.

Reticular Striae are presents at the peripheral area of the lesion.

C.T histopathalogical

Treatment : no specific treatment

115
Q
A

pigmented lichen planus lesions

pigmented papules with keratotic white lesions disposed in a reticular pattern.

C.T : histopathalogical

immunofluorescense can be useful

treatment: has no specific treatment

116
Q
A

angular chelitis

angular chelitis

is a type of chronic candidiasis

bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts

C.T NO NEED

TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field

antifungal antibiotic therapy

117
Q
A

angular chelitis

angular chelitis

is a type of chronic candidiasis

bilateral , painful, can be seen yellow-brownish granular nodules or an erythematous cracked zones with peripheral crusts

C.T NO NEED

TREATMENT:MICONAZOLE GEL 2% 4-6 APPLICATIONS A DAY BOTH ON TH MUCOSA and the prosthetic field

antifungal antibiotic therapy

118
Q
A

atrophic chronic candidiasis

chronic atrophic candidiasis (prosthesis candidiasis)

LOCATED MAINLY ON THE HARD PALATE

HAS 3 stages: 1st:red hyperemic punctiform zones on the salivary glandsholes 2nd:diffuse erythema on the hard palate 3rd: papilary hyperplasia

pain and burning is common

C.T : immunofluorocense examination

treatment: nystatin sol 100.000u/ml 4times a day

amphotericin B suspension 100mg/ml 4 times a day

miconazole gel 2% 4*aday

new prosthetic device , rigorous oral hygiene

remove the prosthetic at nights

119
Q
A

acute atrophic candidiasis

acute atrophic candidiasis

erythematous or stomatitis following antibiotic therapy

clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )

located mainly on the tongue and hard palate

{depapilation of the tongue is prsent }

C.T: direct microscopic examination , culture media

treatment: topical or systemic anti fungal therapy

120
Q
A

acute atrophic candida

acute atrophic candidiasis

erythematous or stomatitis following antibiotic therapy

clinical signs: red congested swallon mucosa covered by small white zones (pseudomembranous )

located mainly on the tongue and hard palate

{depapilation of the tongue is prsent }

C.T: direct microscopic examination , culture media

treatment: topical or systemic anti fungal therapy

121
Q
A

acute pseudomembranous candidiasis

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

122
Q
A

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

ACUTE PSEUDOMEM CANDIDI

123
Q
A

pseudomembranous candidiasis

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

124
Q
A

pseudomem candid

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

125
Q
A

acute pseudomembranous candidiasis

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

126
Q
A

pseudomembranous candida

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

127
Q
A

acute pseudomembranous candid

acute pseudomembranous candidiasis

in this situation the mouth is dry and burning with dyphagia

white or white yellowish patches that can be easily wiped away to reveal the erythematous beneath

located : can be seen everywhere in oral cavity but mostly palate , tongue , jugal mucosa

C.T: based on clinical examination and culture media on different media and direct microscopic examination

128
Q
A

scarlet fever

cold seasons and children

General symptoms: shiver, vomiting, nausea, headache

fver, lymph adenopathy

two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days

2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .

complementary test : culture of type A streptococcus

treatment: antibiotics erythromycin , penicillin

129
Q
A

scarlet fever

cold seasons and children

General symptoms: shiver, vomiting, nausea, headache

fver, lymph adenopathy

two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days

2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .

complementary test : culture of type A streptococcus

treatment: antibiotics erythromycin , penicillin

130
Q
A

scarlet fever

cold seasons and children

General symptoms: shiver, vomiting, nausea, headache

fver, lymph adenopathy

two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days

2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .

complementary test : culture of type A streptococcus

treatment: antibiotics erythromycin , penicillin

131
Q
A

scarlet fever

cold seasons and children

General symptoms: shiver, vomiting, nausea, headache

fver, lymph adenopathy

two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days

2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .

complementary test : culture of type A streptococcus

treatment: antibiotics erythromycin , penicillin

132
Q
A

scarlet fever

cold seasons and children

General symptoms: shiver, vomiting, nausea, headache

fver, lymph adenopathy

two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days

2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .

complementary test : culture of type A streptococcus

treatment: antibiotics erythromycin , penicillin

133
Q
A

scarlet fever

cold seasons and children

General symptoms: shiver, vomiting, nausea, headache

fver, lymph adenopathy

two stages: 1” Enanthema : exfoliating glossitis with angina ( suffocative pain) associated with erythema of tonsills pillars , ovula, soft palate, not on the hard palate.<< tongue becomes extremely congested and it gets redwith glossy aspect and shows the CAT TONGUE aspect. heals in10-12 days

2” Exanthema : dyfussed erythema on the skin giving skin a harsh aspect .

complementary test : culture of type A streptococcus

treatment: antibiotics erythromycin , penicillin

134
Q
A

plummer-vinson Iron def anemia

angular chelitis can be present mostly

general signs: weight loss

pale face , dysponea , headache, hair and nail fragility

oral signs:burning sensation of the tongue, atrophy of filliform and fungiform papilla , dorsal surface of the tongue becomes red-glossy and smooth

*******

in case of plummer-vinson syndrom and hyperchromic anemia oral manifestations are accompanied by dysphagia caused by painful erosions of esophagus

C.T srium iron test

haemoglubin

hematocrit(low level)

treatment:m increasing the iron through supplements and real food

135
Q
A

Iron def anemia

angular chelitis can be present mostly

general signs: weight loss

pale face , dysponea , headache, hair and nail fragility

oral signs:burning sensation of the tongue, atrophy of filliform and fungiform papilla , dorsal surface of the tongue becomes red-glossy and smooth

*******

in case of plummer-vinson syndrom and hyperchromic anemia oral manifestations are accompanied by dysphagia caused by painful erosions of esophagus

C.T srium iron test

haemoglubin

hematocrit(low level)

treatment:m increasing the iron through supplements and real food

136
Q
A

Iron def anemia

angular chelitis can be present mostly

general signs: weight loss

pale face , dysponea , headache, hair and nail fragility

oral signs:burning sensation of the tongue, atrophy of filliform and fungiform papilla , dorsal surface of the tongue becomes red-glossy and smooth

*******

in case of plummer-vinson syndrom and hyperchromic anemia oral manifestations are accompanied by dysphagia caused by painful erosions of esophagus

C.T srium iron test

haemoglubin

hematocrit(low level)

treatment:m increasing the iron through supplements and real food

137
Q
A

homogenous erythroplakia

red patches ,can be anywhere in the oral cavity ***common loc : tongue , soft palate, pillars, floor of the mouth

C.T: BIOPSY IS MANDATORY IN ALL CASES OF ERYTHROPLAKIA SINCE THEY HAVE A 90% POTENTIAL TOBECOME SQUAMOUS CELL CARCINOMA

HISTOPATHALOGICAL EXAMINATION

treatment : same principle as in the case of leukoplakia eliminate the irritating factor and monitor the lesion for 1-2 weeks then performing TOLUIDINE BLUE staining test.

138
Q
A

pernicious anemia (fatal)

mostly happens on the tongue associated with pain,burning sensation , loss of taste, red glossy aspect and smooth depapillated <<hunter-glossitis>> aspect

the rst of the oral mucosa is pale.

C,T : haemoglubin and serum vit b12 test

myelogram (bone marrow)

erythrocytes

treatment:topical applications of benadryl or viscous xylocaine 2% rinse , several times a day

139
Q
A

acute leukemia

clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy

C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation

treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.

thrombin sponges in case of gingival bleeding.

140
Q
A

acute leukemia

clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy

C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation

treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.

thrombin sponges in case of gingival bleeding.

141
Q
A

acute leukemia

clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy

C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation

treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.

thrombin sponges in case of gingival bleeding.

142
Q
A

acute leukemia

clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy

C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation

treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.

thrombin sponges in case of gingival bleeding.

143
Q
A

acute leukemia

clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy

C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation

treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.

thrombin sponges in case of gingival bleeding.

144
Q
A

acute leukemia

clinical signs: hyperplastic swelling of vestibular and oral side of the mouth , pale or purplish gingiva , gingival hyperplasia, dental mobility , tonsil hypertrophy

C.T lab examination of the peripheral blood and bone marrow myelogram or medulogram >>>leukemic cells differentiation

treatment: send the patient to a haemotologist …. any dental procedure needs the approval or presence of the haemotologist.

thrombin sponges in case of gingival bleeding.

145
Q
A

chronic leukemia

clinical: less severe than the acute form

pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia

leukemic nodules can be observed on the palatinenfiber-mucosa

C,T : peripheral blood analysis

medulograma>>>bone marrow analysis tosee if there is any leukemic cells

also send the patient to th haemotologist

treatment:like the acute one >>>>

send tohaemotologist

thrombin sponge in case of bleeding

146
Q
A

chronic leukemia

clinical: less severe than the acute form

pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia

leukemic nodules can be observed on the palatinenfiber-mucosa

C,T : peripheral blood analysis

medulograma>>>bone marrow analysis tosee if there is any leukemic cells

also send the patient to th haemotologist

treatment:like the acute one >>>>

send tohaemotologist

thrombin sponge in case of bleeding

147
Q
A

chronic leukemia

clinical: less severe than the acute form

pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia

leukemic nodules can be observed on the palatinenfiber-mucosa

C,T : peripheral blood analysis

medulograma>>>bone marrow analysis tosee if there is any leukemic cells

also send the patient to th haemotologist

treatment:like the acute one >>>>

send tohaemotologist

thrombin sponge in case of bleeding

148
Q
A

chronic leukemia

clinical: less severe than the acute form

pale oral mucosa , sometimes associated with ulcerated causes, gingival hyperplasia

leukemic nodules can be observed on the palatinenfiber-mucosa

C,T : peripheral blood analysis

medulograma>>>bone marrow analysis tosee if there is any leukemic cells

also send the patient to th haemotologist

treatment:like the acute one >>>>

send tohaemotologist

thrombin sponge in case of bleeding

149
Q
A

infectious mono neucleosis(kissing disease)

Epstain barr virus

transmitted through saliva

generally it has fever, pharyngitis , tonsilitis, lymh adenopathy, weakness , malaise

orally : petechiae (dark red dots ) in purpura is like rash or dark red bleeding dots

on the SOFT and HARD palate

can be associated with necrotsing acute gingivitis

diffused erythema of the oram mucosa

C,T test of specific antibodies

treatment: antiseptic adn topical anesthetic agents (supportive)

150
Q
A

thrombocytopenic purpura

petechiae, ecchymoses and haematoma on the buccal mucosa and palate associated with spontanious bleeding from the gingiva

C.T: MYELOGRAM

PLATELET TEST

COAGULATION TIME

TREATMENT: systematic steroids

splenectomy

platelet transfusion

151
Q
A

thrombocytopenic purpura

petechiae, ecchymoses and haematoma on the buccal mucosa and palate associated with spontanious bleeding from the gingiva

C.T: MYELOGRAM

PLATELET TEST

COAGULATION TIME

TREATMENT: systematic steroids

splenectomy

platelet transfusion

152
Q
A
153
Q
A