Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Oral Patho > white lesions > Flashcards

white lesions Flashcards

(80 cards)

Start Studying
1
Q

What four primary factors determine the color of normal oral mucosa?

A

Vascularity, melanin pigmentation, epithelial thickness, and keratinization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A brownish oral mucosal discoloration usually indicates excess of which pigment?

A

Melanin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A bluish discoloration of oral mucosa usually indicates what type of lesion?

A

A vascular lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A yellowish discoloration of oral mucosa usually suggests which systemic condition?

A

Jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Microscopically, what two changes do all white lesions share?

A

Abnormal keratinization and increased epithelial thickness through hyperplasia or hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define acanthosis.

A

Increased thickness of the prickle cell layer due to increased number of prickle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define epithelial hyperplasia.

A

Increase in the number of epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define epithelial hypertrophy.

A

Increase in the size of epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List the six main etiological categories of white lesions of the oral mucosa.

A

Hereditary, reactive (traumatic), idiopathic, infective, dermatological, and neoplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name two hereditary white lesions.

A

Leukodema and white sponge nevus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give two examples of reactive (traumatic) white lesions.

A

Frictional keratosis and aspirin burn (chemical) or pizza burn (thermal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which infective agents cause oral white lesions listed in the document?

A

Candida albicans (candidiasis) and Epstein–Barr virus (hairy leukoplakia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which dermatological disease commonly produces bilateral oral white lesions?

A

Lichen planus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the principal malignant neoplastic white lesion discussed?

A

Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define leukodema.

A

A racial, generalized opacification of the buccal mucosa considered a normal variation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Leukodema is most common in which demographic group?

A

Black women (American, African)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What clinical maneuver helps distinguish leukodema from other white lesions?

A

Stretching the cheek, which causes the white appearance to diminish or disappear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List three lesions included in the differential diagnosis of leukodema.

A

Leukoplakia, white sponge nevus, habitual cheek biting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

State two key histological features of leukodema.

A

Intracellular edema (spongiosis) of prickle cells and thicker epithelium with parakeratinization and acanthosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What genetic inheritance pattern does white sponge nevus follow?

A

Autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mutations in which keratin genes are responsible for white sponge nevus?

A

Keratin 4 and keratin 13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

At what age does white sponge nevus typically reach maximum size?

A

Adolescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Give three intra‑oral sites frequently affected by white sponge nevus.

A

Buccal mucosa, palate, gingiva (also floor of mouth, alveolar mucosa, tongue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Does stretching the mucosa cause white sponge nevus lesions to disappear?

A

No, the lesion persists when stretched

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Describe the typical clinical appearance of white sponge nevus.
Thickened, folded, soft white patch with spongy consistency, usually bilateral and symmetrical
26
What is the recommended treatment for white sponge nevus?
None; reassurance only because the condition is benign
27
List two key microscopic features of white sponge nevus.
Acanthosis with spongiosis and shaggy hyperparakeratosis
28
Name four common irritants that can cause frictional keratosis.
Habitual cheek biting, orthodontic appliances, ill‑fitting dentures, broken/rough carious teeth or mal‑aligned teeth
29
How is the diagnosis of frictional keratosis confirmed clinically?
By removing the source of irritation; the lesion resolves once the irritant is eliminated
30
What histologic feature distinguishes frictional keratosis from dysplasia?
Thick hyperkeratosis without epithelial dysplasia
31
Differentiate hyperorthokeratinization and hyperparakeratinization.
Hyperorthokeratinization has flattened cells without nuclei and an underlying granular layer; hyperparakeratinization retains pyknotic nuclei in superficial cells and lacks a granular layer
32
Why can placing aspirin next to a painful tooth create a white oral lesion?
Acetyl salicylic acid causes chemical burn leading to epithelial sloughing necrosis and a white necrotic surface
33
Chronic low‑grade chemical insult from aspirin results in what epithelial change?
Hyperkeratosis
34
Smokeless tobacco placed in the vestibule produces a white lesion primarily due to what?
Chemical irritation from tobacco constituents
35
What common food injury is termed a 'pizza burn'?
Acute thermal trauma causing grayish‑white necrotic epithelium surrounded by erythema
36
Name two factors that contribute to smoking‑induced keratosis.
Hyperkeratinization from heat/fumes and carcinogenic chemicals (nicotine, tar)
37
Nicotinic stomatitis typically affects which oral site?
The palate, especially in pipe or cigar smokers and reverse smokers
38
What characteristic appearance do minor salivary gland duct openings show in nicotinic stomatitis?
Small red spots (umbilicated) surrounded by white thickened mucosa
39
Is nicotinic stomatitis considered premalignant?
Generally no; it has little or no risk of malignant transformation and regresses after smoking cessation
40
What percentage of people normally carry Candida albicans in the mouth?
30–50%
41
List five predisposing factors for oral candidiasis.
Leukemia, uncontrolled diabetes, xerostomia, heavy smoking, corticosteroid therapy (also antibiotics, dentures, menopause, etc.)
42
Name four clinical patterns of oral candidiasis under the new Neville 2008 classification.
Pseudomembranous, erythematous, central papillary atrophy, chronic multifocal candidiasis, angular cheilitis, chronic atrophic (denture stomatitis), candidal leukoplakia, mucocutaneous, endocrine
43
Which type of candidiasis presents as removable white plaques resembling curdled milk?
Pseudomembranous candidiasis (thrush)
44
Scraping pseudomembranous candidiasis leaves what type of mucosal surface?
A raw erythematous or normal‑appearing mucosa
45
Which form of candidiasis is commonly called 'antibiotic sore mouth'?
Erythematous (acute atrophic) candidiasis
46
Chronic atrophic candidiasis is most often associated with what prosthetic factor?
Continuous wearing of maxillary dentures with poor hygiene
47
Loss of vertical dimension can cause which candidal‑related condition at the mouth corners?
Angular cheilitis
48
Candidal leukoplakia is another term for which clinical subtype?
Chronic hyperplastic candidiasis
49
Which staining technique easily demonstrates candidal hyphae in biopsy specimens?
Periodic acid–Schiff (PAS) stain
50
List three topical or systemic antifungal agents used to treat oral candidiasis.
Nystatin, clotrimazole, fluconazole (also amphotericin B, ketoconazole)
51
Hairy leukoplakia is caused by infection with which virus?
Epstein–Barr virus (EBV)
52
What is the classic intra‑oral site for hairy leukoplakia?
Bilateral lateral borders of the tongue
53
Describe the clinical appearance of hairy leukoplakia.
Parallel whitish raised keratotic vertical lines producing a 'hairy' surface
54
Is hairy leukoplakia considered a precancerous lesion?
No, it is not premalignant
55
Hairy leukoplakia is a common oral manifestation of which systemic disease?
AIDS (HIV infection) or immunosuppression post‑transplant
56
Name two laboratory methods to demonstrate EBV in hairy leukoplakia.
In situ hybridization and PCR (also immunohistochemistry, Southern blot, electron microscopy)
57
Which three conditions comprise Grinspan’s syndrome?
Lichen planus, diabetes mellitus, and hypertension
58
What is the most accepted pathogenesis of lichen planus?
Autoimmune T‑cell mediated damage to basal keratinocytes
59
Oral lichen planus shows a characteristic bilateral pattern most commonly on which site?
Posterior buccal mucosa
60
What term describes the fine white lace‑like network seen in reticular lichen planus?
Wickham’s striae
61
Which variant of lichen planus presents as white plaques resembling leukoplakia?
Hypertrophic (plaque) type
62
Which variant presents as diffuse red mucosa with burning and fine striae?
Atrophic type
63
Which variant involves shallow ulcerations covered by yellow fibrin and is painful?
Erosive type
64
What form of lichen planus features subepithelial fluid‑filled swellings?
Bullous type
65
What are Civatte bodies?
Eosinophilic apoptotic basal keratinocytes seen in lichen planus
66
What type of lymphocytic infiltrate is characteristic of lichen planus?
A dense, band‑like subepithelial infiltrate of T‑cells (CD4 helper and CD8 suppressor)
67
Liquefaction degeneration affects which epithelial layer in lichen planus?
Basal cell layer
68
Name two topical agents commonly used to manage symptomatic oral lichen planus.
Topical corticosteroids (e.g., triamcinolone acetonide in orabase) and topical retinoids
69
What oral condition can mimic lichen planus and is triggered by certain systemic drugs or metallic restorations?
Lichenoid drug reaction
70
How is nicotinic stomatitis managed?
Advise smoking cessation; the lesion is usually reversible
71
What distinguishes aspirin burn histologically from lichenoid drug reaction?
Aspirin burn causes coagulative necrosis whereas lichenoid drug reaction does not
72
Which neoplastic lesion listed is benign and presents as exophytic white papillary growth?
Squamous cell papilloma
73
What developmental‑appearing lesion on the midline dorsum of the tongue is now considered candidal in origin?
Central papillary atrophy (median rhomboid glossitis)
74
Which opposing lesion may appear on the palate opposite a median rhomboid glossitis?
Kissing lesion due to chronic candidiasis on the palate
75
Name two nutritional deficiencies that can predispose to angular cheilitis besides Candida infection.
Vitamin B12 deficiency and folic acid deficiency
76
What combination of systemic endocrine problems with chronic candidiasis is termed endocrine candidiasis syndrome?
Hypoparathyroidism with chronic mucocutaneous candidiasis (accept endocrine-candidiasis syndrome)
77
What is the first step in managing chronic atrophic candidiasis associated with dentures?
Re‑evaluate denture hygiene/fit and reline or remake the denture while prescribing antifungals
78
Which antifungal drug can be incorporated into the denture base for localized delivery?
Nystatin
79
Which lymphocyte subtypes predominate in the subepithelial band of lichen planus?
CD4 helper T‑cells and CD8 cytotoxic/suppressor T‑cells
80
Which form of smoking involves placing a lit cigarette in the mouth reverse‑end and is strongly associated with nicotinic stomatitis?
Reverse smoking

Oral Patho (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions