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305 > 14- Pigmented Lesions > Flashcards

14- Pigmented Lesions Flashcards

1
Q

What are 2 main examples of non-melanin discolorations?

A

1.) Amalgam
2.) Graphite

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2
Q

What are 2 main examples of melanin-associated discolorations?

A

1.) Focal
2.) Generalized

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3
Q

What are amalgam tattoos?

A

They are amalgam that is traumatically introduced into the mucosa.

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4
Q

How do amalgam tattoo’s present in the oral mucosa?

A

They present as a gray/black macule (flat lesion)

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5
Q

What can occur over time with an amalgam tattoo?

A

It may enlarge overtime.

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6
Q

How can a diagnosis of an amalgam tattoo be seen?

A

With radiographs or a biopsy.

  • no treatment needed for amalgam tattoo
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7
Q

What is a graphite tattoo?

A

They are graphite, generally from pencils that can be implanted into the palatal mucosa.

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8
Q

What are oral melantonic macule?

A

-They are a benign brown macule
-Idiopathic (unknown)
- Increased amount of melanin deposition (a lot of melanin deposition)

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9
Q

Where the most common sites for an oral melanotic macule?

A

In the lip vermillion, buccal mucosa, gingiva

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10
Q

What are the clinical presentations of an oral melanotic macule?

A

They are well demarcated & oval shaped
They have a brown or black in colour
Non cancerous risk

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11
Q

How do we diagnose an oral melanotic macule?

A

Through a biopsy:
needed to rule out melanoma

  • no tx needed after biopsy
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12
Q

What are melanocanthoma?

A

They are a rare, benign melanosis of skin.
(thought to represent a reactive process)

  • it is not a neoplastic or potentially malignant condition
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13
Q

What are the demographics for melanocanthoma?

A
  • typically in darker pigmented people
  • female predilection
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14
Q

Where do we typically see a melanocanthoma?

A

In the buccal mucosa

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15
Q

How are melanocanthomas characterized?

A

They are characterized by multiple dendritic melanocytes throughout the epithelium

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16
Q

How do we treat melanocanthomas?

A

It usually resolves on its own

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17
Q

What are melasma’s?

A

THey are hyperpigmentation of sun-exposed skin.

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18
Q

What are the causes of melasma?

A

They are associated with sun exposure, pregnancy & birth control use.

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19
Q

What are the demographics of melasma?

A

In females
3rd-6th decade
Increases during certain periods of time, such as pregnancy

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20
Q

What are some of the characteristics associated with melasma?

A

They represent an increased melanin in the basal layer
they slowly fade over time
no tx is required (bleaching creams can be used to improve aesthetics)

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21
Q

What is melanoma?

A

They are a malignant neoplasm of melanocytes
3rd most common skin cancer
1.) Basal cell carcinoma
2.) Squamous cell carcinoma

Oral melanoma (extremely aggressive)

22
Q

What are the causes of melanoma?

A

1.) UV radiation for skin melanoma
2.) Unknown for oral melanoma

23
Q

What are the different types of melanoma?

A

1.) Superficial spreading
2.) Nodular
3.) Lentigo maligna
4.) Acral lentiginous

24
Q

What is the most common type of melanoma?

A

Acral lentiginous

25
Q

What are the clinical features of melanoma?

A
  • They are pigmented lesions that grow rapidly
  • They start as a macule, & often will grow into a mass
26
Q

What are the diagnostic procedures of melanoma?

A

1.) Biopsy is mandatory
2.) Condition is why biopsy has all brown patches

27
Q

What do we treat melanoma?

A

1.) Radical surgical excisions
2.) Consideration of clinical trials due to the poor prognosis of oral melanoma

28
Q

Where is physiologic pigmentation most prominent in individuals?

A

Prevalent in people with increased melanin: darker the skin, the more intense oral pigmentation

29
Q

Where can we typically see physiologic pigmentation?

A

In the gingiva, but also on the buccal mucosa & tongue.

30
Q

What is smoker’s melanosis?

A

It is a form of reactive melanosis in which melanin deposition in response to smoke irritation

31
Q

Where can we typically find smoker’s melanosis?

A

In the gingiva & buccal mucosa

32
Q

What is a method to reduce smoker’s melanosis?

A

Pigmentation can slowly disappear with smoking cessation.

33
Q

What is reactive melanosis?

A

It is an increase in melanin that can also be seen in response to chronic mucosal trauma`

34
Q

What kind of forms of trauma can lead to reactive melanosis?

A

1.) Mechanical trauma
2.) Chronic inflammation ie. Lichen planus

35
Q

Is there treatment required for reactive melanosis?

A

No tx required, however pigmentation may persist.

36
Q

What is Peutz-Jeghers syndrome?

A

It is an AD condition:
STK11 gene on chromosome 19

37
Q

How is Peutz-Jeghers characterized?

A

It is an intestinal polyps & oral/perioral pigmentation.

38
Q

When does Peutz-Jeghers syndrome become more noticeable?

A

It becomes more noticeable during childhood.

39
Q

What are the clinical presentations of Peutz-Jeghers syndrome?

A

They have multiple small freckles on lip vermilion & mucosa

40
Q

T or F, In Peutz-Jeghers Syndrome, intestinal polyps are benign growths

A

True, meaning Peutz-Jeghers Syndrome is benign & are not precancerous.

41
Q

What leads to the rise of addison’s disease?

A

It is due to primary adrenal cortical insufficiency.

42
Q

What are the causes of Addison’s disease?

A

The pigmentation can cause excess ACTH release from the pituitary gland.

43
Q

What is the purpose of ACTH?

A

It is released to increase release of hormones from adrenal cortex & helps stimulate the melanocytes.

44
Q

What are the signs & symptoms of Addison’s disease?

A

1.) Fatigue, depression
2.) Weakness
3.) Hypotension
4.) Salt craving
5.) Generalized skin hyperpigmentation

45
Q

What is the treatment required for Addison’s disease?

A

The replacement of missing cortisol & other adrenal cortex hormones

46
Q

What are the 2 most common conditions with oral manifestations to Cafe au Lait pigmentation?

A

1.) Neurofibromatosis
2.) Polyostotic fibrous dysplasia

47
Q

What are the characteristics of Neurofibromatosis?

A

Characterized by the development of multiple neurofibromas

As a pigmented lesion:
a.k.a: characterized as a smooth surfaced lesion “Coast of California”

48
Q

What are the oral manifestations of neurofibromatosis?

A

1.) Multiple neurofibromas (soft tissue masses)

49
Q

How is Polyostotic Fibrous Dysplasia characterized as?

A

Characterized as a condition in which bone is converted to fibrous tissue

50
Q

How is polyostotic fibrous dysplasia associated with the Cafe au lait pigmentation?

A

This is due to the cases that exhibit rough, sharp, edged lesions.
“Coast of Maine”

51
Q

What are some of the oral manifestations of Polyostotic fibrous dysplasia?

A

They have fibrous dysplasia of the craniofacial bone.

52
Q

Wha are the 5 varieties of medications that induce oral pigmentation?

A

1.) Tranquilizers

2.) Antibiotics: minocycline

3.) Antifungals: ketoconazole

4.) Antimalarials:
- chloroquine
- Hydroxychloroquine

5.) Hormone therapy:
- Estrogen

305 (12 decks)

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