White Lesions (new) Flashcards
(37 cards)
1
Q
White Surface Lesions
Epithelial Thickening
A
Asymptomatic
Rough
DO NOT rub off
2
Q
12 White Lesion Epi Thickening
A
- White SPonge Nevus
- Frictional Keratosis
- Hairy Tongue
- Hairy Leukoplakia
- Lichen Planus
- Leukoedema
- Geographic Tongue
- Lichenoid Reaction
- Nicotinic Stomatitis
- Smokeless Tobacco Keratosis
- Linea Alba/ Morsicatio
- Leukoplakia
3
Q
White Sponge Nevus Apperance
A
- Multiple white rough surface lesions through out oral cavity
- Symmetrical
- Thickened
- Corrugated/velvety
- Diffuse plaques
- Bilateral on buccal mucosa
- Also on ventral tongue, labial/alveolar mucosa, soft palate, floor of mouth
4
Q
White SPonge Nevus
Cause
Tx
A
- Autosomal dominant inheritance
- Mutation of keratin gene, abnormal production
- May involve anal and genital
- Other family memeber may have
- Appears in early childhood
- Not premalignant
- No tx needed
5
Q
Frictional Keratosis
Apperance
Cause
Treat
A
- White due to chronic rubbing/friction
- Anywhere in oral cavity
- Should resolve after removal of causative agent
- Otherwise no tx needed
6
Q
Hairy Tongue
Apperance
Cause
Treat
A
- Elongation of filiform papilae due to accumulation of keratin on the dorsumof tongue
- Associated with lack of abrasion of tongue
- Treat; brush or scrape
7
Q
Hairy Leukoplakia
Apperance
Cause
Treat
A
- Epithelial thickening of the lateral surfaces of the tongue
- Thickened parakeratin
- Surface corrugations
- Acanthotic epithelium
- Present in immunocompromised patients HIV, transplant
- Treat: None
8
Q
Leukoedema
Apperance
Distribution
Cause
Diagnosing
Treat
A
- Apperance
- White, opalescent, filmy, folded surface, not rough
- Distribution
- bilateral buccal mucosa
- Cause
- common, asymptomatic, more easily recognized in African Americans
- Diagnose
- white apperance decreases when stretched
- No treatment needed
9
Q
Erythema Migrans
Distribution
Apperance
Due to
Treat
A
- Commonly seen on ant 2/3 tongue and ventral and lateral surfaces
- Apperance
- Red patches with white border
- multiple well-demarcated, irregular, sharply defined tortous, yellow-white border
- Due to atrophy of filiform papillae with elevated white border
- Treat
- not needed, topical steroids for symptomatic lesions
10
Q
Lichen Planus
Cause
Distribution
A
- Common dermatoligical disease
- Oversensitivity reaction of T lymphocytes
- Lesions are multifocal
- Typically bilaterally buccal mucosa
11
Q
Lichen Planus: Reticular Pattern
Apperance
Treat
A
-
Wickhams Striae
- white lacy network with underlying erythema
- Wax and wane over weeks and months
- Asymptomatic no treatment needed
- If burning then topical corticosteroids
12
Q
Lichen Planus: Errosive Pattern
Apperance
Treat
A
- Central area of ulceration painful
- Psudomembrane with erythema and possible Wickhams
- May present as desquamative gingivitis
- Treat
- topical corticosteroids
- Flareups require reapplicatoin or prophylatic treatment
- Severe cases- Systemic Corticoid therapy
13
Q
Lichenoid Mucositis
Causes
Dist
A
- Clinical and micro findings similar to lichen planus
- Causes:
- Rxn to flavoring agents (cinammon mint)
- Rxn to medication
- Graft vs Host disease
- May be focal or multifocal
14
Q
Nicotinic Stomatitis
A
- Hard palate of smokers
- No treatment
- Almost no potential for transformation to squamous cell carcinoma
15
Q
Line Alba
Cause
Distribution
Treat
A
- Common alteration of buccal mucosa
- Pressure, frictional irritation or sucking trauma from the facial surfaces of the teeth
- Usually bilateral
- No treatment
16
Q
Morsicatio Buccarum
Cause
Distribution
Apperance
Treat
A
- Chronic check chewing
- Labial mucosa= Morsicatio labiorum
- Tongue= Morsicatio linguarum
- Usually bilateral
- Thickened, shredded, areas of white hyperkeratosis
- No treat needed
17
Q
Leukoplakia Definition
A
- White patch or plaque that cannot be characterized clinically or pathologically as any other disease
- Strictly a clinical term and does not imply diagnosis
- Dependent on the exclusion of other white lesions
18
Q
Lesions that must be excluded before the term Leukoplakia can be used 9
A
- White sponge nevus
- Frictional Keratosis
- Hairy tongue or lukoplakia
- Leukoedema
- Geo tongue
- Lichen Planus/Lichenoid Mucositis
- Tobacco pouch hyperkeratosis
- Nicotine stomatits
- Morsicatio (chronic chewing on tissue)
19
Q
Leukoplakia must be microscopically diagnosed by biopsy and will be one of the following
A
- Hyperkeratosis
- Epithelial dysplasia
- Epithelial dysplasia
- Carcinoma-in-situ
- Superficial squamous cell carcinoma
20
Q
Hyperkeratosis
A
- Callous
- Not premalignant
- Does not need removal
21
Q
Epithelial Dysplasia
A
- Atypical cells confined to the cells of the epithelium
- Considered premalignant
- mild dysplasi not removed
- Moderate may be removed
- Severe must be removed
22
Q
Carcinoma In-situ
A
- cancer confined to the epithelium
- Will eventually invade
- MUST be removed
23
Q
Superficial Squamous Cell Carcinoma
Treat
A
MUST be removed
24
Q
White Surface Debris Lesions
A
- Symptomatic
- Rub off
- Underlying erythema
- Include
- Candidosis
- Burn
- Dentrifice-associated slough
25
Candidosis
Predisposing factors
* Caused by Candida albicans
* Predisposing factors
* Immunodeficiency
* Acquired immunosuppresion
* Endocrine disturbances
* Diabetes mellitus
* Corticosteroid therapy
* Systemic antibiotic therapy
* Xerostomia
* Poor oral hygeine
26
Pseudomembranous Candidosis Thrush
App
Symptoms
Assoc with
* White plaques that rub off leaving an erythematous base
* Pain or burning sensation
* Assoc with xerostomia, AB, decreased host resistance
27
Erythematous Candidosis
* RED variations
* Acute Erythematous candidosis
* Chronic
* Angular Chelitis
* Median Rhomboid Glossitis
28
Management of Candidosis
* Cytology smear to confirm
* Antifungal medications
* Topical or systemic
29
Dentrifice-Associated Slough
Apperance
Associated with
* Painless, **grayinsh-white gelatinous membranes** on gingiva, vestibule, floor of mouth, lips
* Most apparent in **morning**
* Associated with **sodium lauryl sulfate and pyrophosphates**
* May cause burning
* Switch toothpaste
30
Chemical Injury Apperance
Mucosa develops white, wrinkled apperance.
Removal of necrotic epithelium reveals red, bleeding tissue
31
Burn apperance
Area of yellow-white **epithelial necrosis**
32
Subepithelial White Lesions general
Asymptomatic Smooth to palpation translucent
33
Subepithelial White Lesions 5
* Congenital cysts
* Palatal cysts of newborn
* Bohns nodules
* Epsteins pearls
* Gingival cysts of newborn
* Subepithelial fibrosis (scar)
* Fordyce Granules
34
Palatal Cysts
2 kinds Cause
* Small developmental inclusion cysts
* **Epsteins pearls**
* **Palatal shelves fusing at midline** entrap small islands of epithelium
* **Bohns nodules**
* Epithelial remnants from **minor salivary glands** on palate entrapped
35
Gingival Cysts of newborn
* Entrapment of dental lamina
* Apperance similar to palatal variant
* Resolve spontaneously
36
Subepithelial Fibrosis (scar)
* Usually poorly defined
* Hx on inkury
* No tx needed
37
Fordyce Granules
* Represent ectopic sebaceous glands
* Yellow, granular plaques and nodules present in clusters
* Commonly on buccal mucosa and lip
* Diagnosis based on clinical basis
* No tx needed
