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Flashcards in Week 4 Deck (38)
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1

Can Leukoplakia be definitively Diagnosed via a biopsy?

NO, the Pathologist will simply say that it is a high probability, but the diagnosis can only be made by the clinician.

2

What is the most important about CLINICAL characteristics while LOOKING at the lesion for leukoplakia?

The margins are EXTREMELY well defined.
-No feathering, very distinct change from normal to "white"

3

Two broad categories for Leukoplakia?
How do you decide between them?

Homogenous and NON-Homogenous
The clinical look of the lesion.

4

Frictional keratosis has what clinical appearance that would NOT make it Leukoplakia?

Feathered margins! Not well defined.

5

Clinical look of homogenous Leukoplakia? (3)

1. Smooth
2. Cracked Mud
3. Slightly opaque

6

Clinical look of NON-homogenous Leukoplakia? (3)

1. Rough
2. Very Opaque
3. Ragged margins

7

Differential for Leukoplakia? (5)

1. Frictional Keratosis
2. Lichen Planus
3. SLE
4. Candida
5. Hairy Leukoplakia (HHV-4)

8

Most to least common location of Leukoplakia? (3/5)
1. Most common
2. (2)
3. (2)

1. Vestibule (most common)
2. Palate, Lip
3. Tongue, FOM

9

Most common sites positive for malignancy? (5)

1. FOM
2. Tongue
3. lip
4. Palate
5. Vestibule

10

Is the severity of Leukoplakia (malignant transformation) worse for those with risk factors (smoking) or without?

It is more often that when a Leukoplakia presents, that if there is not a risk factor, it is MORE likely to be malignant!

11

Proliferative Verrucous Leukoplakia.
-Who?
-

60-70 Y.o. Women (women over 40)

12

Proliferative Verrucous Leukoplakia
-Clinical presentation?

1. Multiple NON-homogenous white plaques
2. Recurring plaques

13

Proliferative Verrucous Leukoplakia
-Malignancy rates

80-100% Transformation to Cancer

14

Fraction of the Epithelium that is dysplastic to Term as Mild, moderate, severe, and In Situ?

Mild-33%
Mod-50%
Sev-66%
In Situ- 100%

15

Most white lesions have this descriptive characteristic (morphology)?

Most white lesions are PLAQUES

16

4 Reasons the lesions appear white

1. Less vascularity
2. Hyperplasia
3. Thickened keratin
4. Edema

17

White lesion examples
that CAN be wiped off

1. Pseudomembranous candidiasis
2. Burns
3. Sloughing traumatic lesions
4. Na+ Lauryl Sulfate Rxn

18

First two concerns when a white lesion is found?

1. How long?
2. Can I scrape it off the surface?

19

Leukoedema
-What is pathognomonic for Leukoedema

Disappears when stretched

20

Leukoedema
-Pain?
-Race?
-Bilateral?

Pain: Painless
Race: African Americans
Bilateral: Yes, bilateral lesions

21

Leukoedema HISTOPATHOLOGY (2)
-Nuclei/Cytoplasm
-Layer of _________ Edema

-Nuclei are Pyknotic (small, bold, purple)
-Spinous Layer has INTRAcellular swelling

22

Leukoedema treatment?

NONE

23

White Sponge Nevus
-Pain
-Age
-Bilateral?

Pain-NONE
Age-PrePubertal
Bilateral-YES

24

White Sponge Nevus
-Other involved locations(4)
-1 Location specifically NOT involved

1. Eso NOT involving the EYES
2. Anus
3. Vagina
4. Vulva

25

White Sponge Nevus
-Where do you find the oral lesions?

ANYWHERE!!!!

26

White Sponge Nevus
Histopathology(2)
-Perinuclear
-The epithelium is ortho or Para?

Perinuclear eosinophilic condensation of Cytoplasm
***of the Prickle cells

Parakeratosis (should be ortho)

27

White Sponge Nevus treatment?

None

28

Hereditary Benign Intraepithelial Dyskeratosis
-Age
-Race?
*HBID/Witkop's disease

-Age is BABY
-Race is Triracial, white, Native American and African American

29

Hereditary Benign Intraepithelial Dyskeratosis
-Lesion locations (2)

Oral (anywhere)
Eyes

30

Hereditary Benign Intraepithelial Dyskeratosis
-Location of oral lesions

ANYWHERE!

31

Hereditary Benign Intraepithelial Dyskeratosis
-Histopath(3)

Hyperplasia
Intracellular edema (with acanthosis)
Big ass Keratinocytes

32

Hereditary Benign Intraepithelial Dyskeratosis treatment?

NONE
*Refer to Ophthalmologist

33

Reactive lesions List them (6)

1. Frictional Hyperkeratosis
2. Tobacco Keratosis
3. Nicotine Stomatitis
4. Hairy Leukoplakia
5. Hairy Tongue
6. Sloughing from Na+ Lauryl Sulfate

34

Frictional Hyperkeratosis
-Cause?

Traumatic, repetitive movements

35

Frictional Hyperkeratosis
-Location

Found near occlusal table (buccal, Labial, and Lingual)

36

Frictional Hyperkeratosis
-Histopath (2)

Hyperkeratosis (like a callus)
LOW inflammation

37

Frictional Hyperkeratosis
-Treatment

Fix frictional problem

38

$$$$$$$ latin term for Cheek biting (2)

Morsicatio buccarum/Lingulum/Labiorum
-Or frictional keratosis