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Oral Medicine > 30 Most Common Oral Lesions 1-8 > Flashcards

30 Most Common Oral Lesions 1-8 Flashcards

1
Q

the 30 most comon oral lesions make up ___% of all reported lesions

A

93%

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2
Q
  • white plaque that does not rub off
  • cannot be identified as any other well known entity
A

leukoplakia

the fact that the lesion starts and stops is more worrisome than if it were one discontinuous lesion; you would want to take multiple incisional biopsies in this case

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3
Q

5 white lesions that can be scraped off

A
  • materia alba
  • white coated tongue
  • burn (thermal, chemical, cotton roll, etc.)
  • pseudomembranous candidiasis
  • toothpaste or mouthwash overdose
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4
Q

can be scraped off

A

materia alba

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5
Q

is white coated tongue symptomatic or asymptomatic? what is the treatment?

A
  • asymptomatic
  • treatment is tongue scraping or brushing
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6
Q
  • asymptomatic
  • wipes off
A

white coated tongue

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7
Q

can be wiped off

history of placing aspirin in this area

A

chemical burn

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8
Q

history of recent dental work, where cotton rolls were used, wipes off

A

cotton roll burn

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9
Q

generalized throughout the mouth, history of toothpaste irritation, wipes off

A

toothpaste allergy

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10
Q

wipes off

A

candidiasis

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11
Q

bilateral on buccal mucosa at occlusal plane, does not wipe off

A
  • linea alba
  • no treatment necessary
  • can be from friction or sucking
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12
Q

goes away when stretched

A

leukoedema

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13
Q

leukoedema is bilaterally present in what percent of african american patients?

A

70-90%

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14
Q

what is the treatment for leukoedema?

A

no treatment necessary

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15
Q

history of smoking

A

nicotine stomatitis

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16
Q

what do the red spots represent?

A

salivary gland duct openings

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17
Q

this is bilateral; what is the etiology?

A

oral hairy leukoplakia, etiology is EBV (patients are usually immunocompromised, and this is often seen in HIV patients)

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18
Q
A

tobacco pouch keratosis

treatment is to move tobacco pouch to a different location or stop using smokeless tobacco

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19
Q

does not wipe off

A

lichen planus

take incisional biopsy

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20
Q

what are the four possibilities of a leukoplakia biopsy?

A
  • hyperkeratosis
  • dysplasia (mild, moderate, severe)
  • carcinoma-in-situ
  • squamous cell carcinoma
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21
Q

what are the 3 high risk sites for leukoplakia?

A

floor of mouth > tongue > lip

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22
Q

what is the best guide to potential progression of oral lesions?

A

degree of dysplasia

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23
Q

severe dysplasia has ___% transformation rate

moderate dysplasia has ___% transformation rate

mild dysplasia has ___% transformation rate

A

16%, 3-15%, <5%

a dx of mild dysplasia does not necessarily warrant excisional biopsy; you can watch it and determine treatment from there

in any case, excision significantly reduces the transformation rate

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24
Q

what is the average transformation time for leukoplakia?

A

4.3 years

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25
Q
A

torus mandibularis

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26
Q
A

torus palatinus

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27
Q

what are some cases where you would recommend removing tori?

A
  • dentures
  • causing problems
  • cosmetics/personal preference
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28
Q

what percent of the population has torus palatinus? are they more common in males or females? caucasians or african americans?

A
  • 20-35%
  • 2:1 F:M
  • C=B
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29
Q

what percent of the population has torus mandibularis? more common in males or females? caucasians or african americans? what percent is bilateral?

A
  • 7-10%
  • M>F
  • C=B
  • 90% bilateral
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30
Q

what is kenalog-10 (or kenalog-40) used for?

A

treats traumatic ulcers

31
Q

when using kenalog-10, how many mg do you need for a 1cm lesion?

A

in kenalog-10, there is 10mg per 1ml of fluid, so for a 1cm lesion, you’d need 10mg, or 1ml

so if the lesion is 3cm, you need 30mg or 3ml kenalog-10

32
Q

when using kenalog-40, how many mg do you need for a 1cm lesion?

A

in kenalog-40, there is 40mg per 1ml of fluid, so for a 1cm lesion, you’d need 10mg (0.25ml)

for a 3cm lesion, you’d need 30mg or 0.75ml of kenalog-40

33
Q

hx of trauma

A

traumatic ulcer

34
Q
A

pericornitis

operculum - fragment of oral soft tissue that overlies some of the occlusal table

35
Q

how can you test whether this is a periodontal abscess or endo?

A

use gutta percha to track it

36
Q
A

fibroma

most common location is the buccal mucosa along the occlusal table

37
Q

what is the most common benign neoplasm of the oral cavity? most common locations?

A

fibroma

buccal mucosa > labial mucosa > tongue > gingiva

38
Q

what is the treatment for a fibroma?

A

surgical excision

39
Q
A

fibroma

40
Q
A

fibroma

41
Q
A

fibroma

42
Q
A

fordyce granules

ectopic sebaceous glands

43
Q
A

fordyce granules

44
Q

___% of the population has fordyce granules

A

80%

45
Q

what are the most common locations for fordyce granules? what is the treatment?

A

buccal mucosa > lips

no treatment

46
Q

clinically blanches under pressure

A

hemangioma

47
Q

what is a hemangioma caused by?

A

benign proliferation of blood vessels

48
Q

hemangiomas affect ___% of children

A

10-12%

49
Q

what is the treatment for hemangioma?

A
  • clinical observation
  • removal - surgery, laser, embolization
  • sclerotherapy
50
Q
A

hemangioma

51
Q

painful, history of recurrence

A

recurrent apthous ulcer, major

52
Q

recurrent aphthous ulcers affect what percent of the population?

A

20-25%

53
Q

recurrent aphthous ulcers occur on __keratinized/non-keratinized__ tissues, and on __bound/non-bound___ mucosa

A

non-keratinized, non-bound mucosa

54
Q

recurrent apthout ulcers are usually how large in diameter? how many lesions are usually present?

A

0.5-1 cm in diameter

1-2 lesions

55
Q

what is the treatment for recurrent aphthous ulcers?

A

topical steroids

56
Q

what 3 pieces of information do you need to make a successful diagnosis of recurrent aphthous ulcers?

A

location + size + number of lesions

57
Q

what is the etiology of recurrent aphthous ulcers?

A
  • “different things in different people”
  • 3 theories - autoimmune, hypersensitivity, and stress
58
Q

what are 7 examples of prescriptions used to treat recurrent aphthous ulcers?

A
  • aphthasol
  • betamethasone
  • temovate
  • decadron
  • lidex
  • kenalog
  • medrol
59
Q

what lesion can have a cauliflower appearance?

A

squamous papilloma

60
Q

___ is a benign proliferation of squamous epithelium

A

papilloma

61
Q

what locations are squamous papillomas most common on?

A

tongue > soft palate

62
Q

are squamous papilloma lesions usually solitary or are there multiple? are they sessile or pedunculated?

A

they are solitary pedunculated wart-like lesions

63
Q

what is the treatment for squamous papilloma lesions?

A

surgical excision

64
Q
A

squamous papilloma

65
Q
A

squamous papilloma

66
Q

what is the differential for a papillary lesion?

A
  • squamous papilloma
  • verruca vulgaris (wart)
  • condyloma acuminatum (venereal wart)
  • focal epithelial hyperplasia (heck’s disease)
  • verucciform xanthoma
  • *sinonasal papilloma is also a variation of a papilloma but would not be included on a differential based on location
67
Q
A

verruca vulgaris

68
Q
A

condyloma accuminatum

69
Q
A

condyloma accuminatum

70
Q
A

focal epithelial hyperplasia

71
Q
A

sinonasal papilloma

72
Q

what is the viral etiology for squamous papilloma?

A

HPV 6 and 11

73
Q

what is the viral etiology for condyloma accuminatum?

A

HPV 16, 18

74
Q

what is the viral etiology for focal epithelial hyperplasia (heck’s disease)?

A

HPV 13, 32

Oral Medicine (10 decks)

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