White, Red, Pigmented Flashcards
(20 cards)
what is a good acronym for white patch lesions
CLINK
CONGENITAL
LICHEN PLANUS
INFECTIVE
NEOPLASTIC
KERATOSIS
what lesion presents on buccal mucosa as faint white lines that fade when stretched
leukoedema
what is white sponge naevus
white thickened, corrugated, velvety plaque
diffuse, smooth
inherited, autosomal dominant
keratin 4+13 genes
no inflammatory changes, acanthotic, thickened epithelium/stratum spinous, oedema
describe hairy leukoplakia
cause
management
non-removable white patch, lateral tongue, finger-like projections
EBV triggered, immunocompromised, HIV, diabetes, steroid
CD4+ T cell count drop
incisional biopsy + immunohistochemistry for EBV
HIV investigation
squamous cell carcinoma red flags
> 3 weeks, >50 y/o
smoking, drinking, previous
non homogenous, non healing ulcer
indurated
exophytic, tissue tethering
non healing socket
difficulty swallowing/speaking
weight loss, appetite loss, numbness, fatigue
what is leukoplakia ?
how is it diagnoses?
name the types
white patch/plaque lesion which cannot be wiped away or characterised
diagnosis of exclusion
homogenous - uniformly white, flat, thin
non-homogenous - diffuse borders, red components, texture/colour abnromalities
verrucous - raised surface, exophytic, warty, gingival/palate 85% MALIGNANT TRANSFORMATION
malignant potential of leukoplakia
2-5% 10 years
pt presents with limited mouth opening, pale/firm fibrous bands on buccal mucosa + soft palate
white lines
loss of elasticity
pain to spicy food
SH - chewing tobacco [paan]
what is ur diagnosis and management
oral sub mucous fibrosis
prevention best, irreversible
MALIGNANT 5%
name 3 different types of keratosis
due to increased keratin at site of trauma
frictional
thermal - smoking, hot
chemical - aspirin
if high risk site then refer
reverse trauma
red patch + no clear cause
thoughts ?
high likelihood of dysplasia
pt presents with a fiery red patch that cannot be characterised, velvety, +/- speckles
what is your diagnosis
what is malignant potential
erythroplakia [erythroleukoplakia]
tobacco use
50% transformation
p53 mutation
REFER URGENTLY
describe granulomatosis with polyangitis
swollen red gingiva, strawberry appearance
fever, weight loss, ent manifestations
systemic vasculitis - potentially fatal
tx with immunosuppressants
give exogenous + endogenous causes of oral pigmentation
exogenous [extrinsic]
- amalgam
- CHX
- tobacco
- heavy metals
endogenous [intrinsic]
- melanin
- racial pigmentation
pt presents with patchy brown pigmentation on their tongue
diagnosis
what tests
why does this happen
Addisons disease
adrenal glands not producing enough steroid, insufficiency leads to increased ACTH via pituitary which stimulates melanocytes
pt presents with freckles on buccal mucosa and lips and GI upset
diagnosis
cause
investigations
management
puetz jehgers syndrome
autosomal dominant STK11 tumour suppressor gene
FBC, endoscopy, risk GI polyps
manage polyps, regular CT/MRI
malignancy risk w polyps
describe melanocytic naevi
blue/black lesion
<1cm
appears in childhood
focal proliferation of melanocytes
describe melanocytic macule
single brown lesion, flat, <1cm, painless, vermillion border
consider biopsy to exclude melanoma
describe kaposi sarcoma appearance
cause
risks
management
redish/blue or brown
oral mucosa palate
vascular neoplasm affecting skin + GI
disorganised epithelial growth, HHV8 associated
immunocompromised, gay man, HIV, older, Italian/jewish
surgery, radio/chemo, HAART
describe melanoma appearance/red flags
what is survival rate
asymmetry, colour/border iregularity, evolving, >6mm
palate, maxilla gingivae
may arise from pigmented naves
5 year survival 25%
