Red Lesions Flashcards

Question

What does the mnemonic WATCH OUT B stand for?

Answer 1

White & Red mix, Always a smoker, Takes forever to heal, Can't find a cause, History of bad stuff, Other health issues, Unexplained weight loss, Temperature spikes/sweats at night.

Answer 2

Do not perform dental treatment unless diagnosis is confirmed, refer immediately to Oral medicine, inform GMP of findings.

Answer 3

Healing of lesions, preventing recurrence, preventing impact on quality of life, managing immunosuppression.

Answer 4

Take a comprehensive history, ask patient concerns, understand normal anatomy, identify red flags, describe the lesion, and call oral medicine specialists.

Answer 5

A structured communication tool for handover in medical settings.

Answer 6

Vesiculobullous conditions are skin or mucous membrane (like the inside of your mouth) problems where blisters form. Think of your skin or the lining of your mouth as having layers, like sheets of paper stacked together. These conditions happen when something causes these layers to separate. When they separate, a space is created, and this space fills up with fluid, forming a blister. "Vesicle" just means a small blister, and "bulla" means a large one. What causes the layers to separate? There are a few main reasons: Immune System Mix-up (Autoimmune): Sometimes, the body's defense system gets confused and mistakenly attacks the "glue" or proteins that normally hold the skin/mucous membrane layers tightly together. When this "glue" is damaged, the layers come apart, and blisters form. (This is common in conditions like Pemphigus vulgaris or Mucous Membrane Pemphigoid). Genetic "Weak Spots": Some people are born with a genetic condition where the parts that hold the skin layers together are naturally weaker. This means blisters can form very easily, sometimes from just minor rubbing. (This is seen in conditions like Epidermolysis Bullosa). Infections: Certain viruses (like Herpesviruses – e.g., Herpes Simplex causing cold sores/genital herpes, or Varicella-Zoster virus causing chickenpox and shingles) or some bacteria can directly damage the skin cells or the connections between them, leading to blisters. Physical Damage: Things like severe burns (thermal blisters), intense friction (friction blisters), or exposure to certain chemicals can physically force the skin layers apart, causing blisters. So, in simple terms, vesiculobullous conditions occur when the layers of your skin or mucous membranes come apart, and the space fills with fluid, creating a blister. The reason for this separation can vary, from your own immune system acting up (like in Pemphigus or Pemphigoid) to genetic factors (like in Epidermolysis Bullosa), infections, or external damage.

Answer 7

Mnemonic for General Principles of Management: The "P.R.I.A." Approach To remember these general management principles, think P.R.I.A. P - PAUSE & PROTECT Pause non-essential dental treatment until a diagnosis is clear and a specialist advises (especially if something like Desquamative Gingivitis - DSG - is suspected). Protect the area from further irritation or inappropriate treatment. R - REFER URGENTLY Refer the patient immediately and with urgency to an Oral Medicine specialist. Discuss referral pathways (private or public). I - INFORM & INTEGRATE Inform the patient's General Medical Practitioner (GMP) of the findings and the referral. Integrate care between dental and medical professionals. A - AIMS OF MANAGEMENT Focus on clear Aims: Achieve healing of lesions and prevent recurrence. Avoid negative impacts on Quality of Life (QoL). Administer and manage immunosuppression effectively (if required) and prevent long-term treatment complications. This P.R.I.A. approach helps ensure that red oral lesions are handled carefully, specialist advice is sought quickly, everyone involved in the patient's care is informed, and the treatment goals are clear.

Answer 8

Okay, here's the concise checklist for assessing red oral lesions, now incorporating specific considerations for Immunobullous Conditions and Periodontal Disease: Concise Checklist: Red Oral Lesions Assessment 1. Initial Check: * [ ] Single Lesion? (Go to Section A) * [ ] Multiple Lesions? / Widespread Redness? (Go to Section B) A. SINGLE Red Lesion Pathway: Investigate Local Factors: [ ] Local irritation (denture, sharp tooth)? [ ] Trauma (biting, mints)? [ ] New oral products (toothpaste, mouthwash, gum)? If Suspected Local Cause: [ ] Advise patient to eliminate suspected cause. [ ] Re-evaluate in 2 weeks. [ ] If Resolved: Monitor. [ ] If Persistent: Proceed below. If NO Obvious Local Cause OR Persistent Lesion: Consider: [ ] Early Immunobullous sign? (Persistent erosion, history of blistering, even if not currently visible?) [ ] Localized Severe Periodontal Issue? (Focused on gums, deep pocket, bleeding, pus?) [ ] Other potentially serious causes (e.g., early neoplasia - look for induration, non-healing ulceration)? Action: Refer for biopsy and/or specialist assessment (Oral Medicine/Periodontist as appropriate). B. MULTIPLE Red Lesions / Widespread Redness Pathway: Note Lesion Locations & Characteristics. Consider the following possibilities: [ ] Immunobullous Condition? (e.g., Pemphigus Vulgaris, Mucous Membrane Pemphigoid) Clues: History of blisters (even if they rupture quickly leaving erosions/ulcers)? Desquamative gingivitis (peeling, raw, red gums)? Lesions on other body surfaces (skin, eyes, genitals)? Action: Refer URGENTLY to Oral Medicine for diagnosis (likely includes biopsy with immunofluorescence). [ ] Periodontal Disease / Severe Gingivitis / Desquamative Gingivitis? Clues: Redness primarily on gums? Swelling, bleeding on probing? Plaque/calculus? Bad breath? Known history of gum disease? (Note: Desquamative gingivitis can be a sign of immunobullous disease or lichen planus too). Action: Perform thorough periodontal assessment. Manage periodontal disease. If desquamative or severe/atypical, refer to Periodontist or Oral Medicine (especially if immunobullous or lichen planus suspected). [ ] Lichen Planus? Clues: Non-migratory red areas, often with white lacy streaks/patches (Wickham's striae)? Commonly on buccal mucosa, tongue, gums? Action: Refer for confirmatory biopsy (Oral Medicine). [ ] Oral Candidiasis (Thrush)? Clues: Multiple red areas, sometimes with removable white patches? Burning sensation? Risk factors (e.g., denture use, antibiotics, dry mouth, immunosuppression)? Sub-type: Median Rhomboid Glossitis: Red, smooth patch in midline of dorsal tongue, non-cyclical, isolated. Sub-type: Erythematous Candidiasis (Denture Stomatitis): Redness under a denture, especially if worn 24/7. Action: Assess further, confirm (e.g., smear if needed), consider antifungal treatment and address predisposing factors. [ ] Geographic Tongue? Clues: Lesions (red areas with whitish borders) primarily on the top/sides of the tongue? Lesions change location/pattern ("move around"), come and go? Action: Reassure (benign condition). Key Reminders (Apply to All): Always perform a thorough medical, dental, and lesion-specific history. If any lesion appears suspicious for malignancy (e.g., indurated, non-healing ulcer, rapid growth, fixation, unexplained lymphadenopathy), prioritize urgent referral for biopsy. This checklist is a guide; clinical judgment is paramount. When in doubt, refer.

Red Lesions Flashcards

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