3. Red lesions Flashcards
What are the main causes of red lesions in the oral cavity?
- infective (bacterial, fungal, viral)
- associated with dermatological disorders
- idiopathic
- neoplastic
What are some examples of an infective cause of a red lesion?
periodontal disease, median rhomboid glossitis, HIV gingivitis
What are some examples of a dermatological disorder associated cause of a red lesion?
erosive lichen planus, discoid lupus erythematosus
What are some examples of an idiopathic cause of a red lesion?
geographic tongue, erythroplakia
What are some examples of an neoplastic cause of a red lesion?
dysplastic lesions, squamous cell carcinoma
What can trigger sensitive or pain in geographic tongue?
acidic or spicy foods
How does median rhomboid glossitis present?
- rhomboid red patch on midline of posterior aspect of anterior 2/3 of dorsal tongue
- asymptomatic
- can sometimes have a reciprocal lesion on the palate opposing the tongue
What causes median rhomboid glossitis?
aetiology uncertain, but most cases associated with candida
What is the histopathology of median rhomboid glossitis?
- loss of lingual papillae
- parakeratosis and acanthosis of the squamous epithelium
- candidal hyphae in parakeratin and associated neutrophils
- chronic inflammatory infiltrate in connective tissue
What is used to highlight candida in histology slides?
PAS
What is the treatment for median rhomboid glossitis?
antifungal medication
- even with successful treatment, the papillae on the dorsum of the tongue do not grow back
What is erythroplakia?
- an oral potentially malignant disorder
- ‘ a red patch that cannot be characterised clinically or pathologically as another definable lesion’
- red ‘velvety’ appearance, smooth or nodular
- less common than leukoplakia
What areas of the mouth are erythroplakia most frequently seen on?
palate, floor of mouth, buccal mucosa
What is erythroleukoplakia?
- oral potentially malignant disorder
- (also called speckled leukoplakia)
- has both leukoplakia and erythroplakia components
- erythroplakias and erythroleukoplakias have high likelihood of malignant transformation
- on biopsy, greater than 90% will be severe dysplasia or carcinoma
What is this?
median rhomboid glossitis
What is this?
erythroplakia
What is this?
erythroleukoplakia (speckled leukoplakia)
