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Oral candidiasis > 6. Benign white and red patches of the oral mucosa > Flashcards

6. Benign white and red patches of the oral mucosa Flashcards

1
Q

What are fordyce spots?

A

Choristoma
Sebaceous glands
Found in upper lip and cheeks

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2
Q

What are Koplik’s spots?

A

Found in oral mucosa when someone has measles.
Disappear when skin rash occurs
White/blue
Range from few to hundreds

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3
Q

What is the chemical formula of aspirin?

A

C9H8O4

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4
Q

What is an aspirin burn caused by?

A

Aspirin is a cyclooxygenase inhibitor.
The chemical injury is caused by acetylsalicyclic acid.

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5
Q

What is Reye’s syndrome?

A

Increase in pressure of the brain and other organs.
It is linked to taking aspirin in young people.
DO not give aspirin to people under 16.

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6
Q

What is simple keratosis?

A

Increase in thickness of the keratinised layer of the epithelium.
Cannot be removed by scrapping.

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7
Q

What is simple keratosis caused by?

A

Irritation such as trauma, smoking, bad hygiene

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8
Q

What is speckled leukoplakia called?

A

Erythroplakia- red and white. This is premalignant.

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9
Q

What is the cause of white sponge naevus?

A

Autosomal dominant condition
Affects 1 in 200000
Due to mutations in genes coding for keratin 4 and 13

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10
Q

What does white sponge naevus look like?

A

Painless white patches appear at young age in cheeks, ventral tongue, floor of mouth.

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11
Q

What is the histology of white sponge naevus?

A

Acanthotic epithelium and parakeratosis
Intracellular oedema
Pyknotic nuclei
Basket weave appearance in epithelium
Perinuclear eosinophilic condensations
Basal layer intact, no inflammation
Some abnormality in the desquamation process

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12
Q

What is the aetiology of lichen planus?

A

Altered expression of keratinocytes
Instead of class 1, they express class 2 histocompatibility antigens which transforms them into antigen presenting cells. The keratinocytes start presenting themselves as antigens to T cells, which generates an immune response by cytotoxic cells against the epithelium.

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13
Q

What is the oral appearance of lichen planus?

A

white, Wickhan’s striae present in buccal mucosa and other sites but uncommon on floor of mouth
Cannot be removed by a gauze

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14
Q

What is the histology of Lichen planus?

A

Parakeratosis
Irregular acanthosis- triangular saw tooth rete ridges
Liquefaction or degeneration of the basal cell layer
Band like lympho-histiocytic infiltrate under the epithelium- lymphocytes and histocytes, not plasma cells or neutrophils
Presence of civatte (hyaline) bodies- apoptotic features

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15
Q

What are the 6 different types of lichen planus?

A

Erosive- extensive areas with ulceration
Plaque like- white patches
Reticular- lace like
Bullous- sup-epithelial bullae
Papular- small white papules
Atrophic- diffuse red lesions- erythroplakia

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16
Q

What are the 2 forms of lupus erythematous?

A

Chronic discoid LE- mostly on skin, sometimes on face forming butterfly pattern
Systemic LE- disseminated disease

17
Q

What is the aetiology of LE?

A

Immunological/genetic hypersensitivity of B lymphocytes

18
Q

Which LE has oral lesions?

A

Chronic discoid LE
Erythematous patches with white keratotic borders, can have radiating striae

19
Q

Histology of LE?

A

Hyperplastic epithelium
Subepithelial and deep perivascular lymphocytic infiltration
Liquefaction of basal cells
IgG and C in basement membrane zone
Keratin plugging- keratin is not just present at the surface of the epithelium but goes down into the rete pegs

20
Q

What happens to the fingers in Raynaud’s phenomenon?

A

Intermittent vasospasms- white to blue to red
Vasoconstriction makes white, then they get hypoxic white makes them blue, then they vasodilate again to make them red.

21
Q

What is the cause of Raynaud? What diseases is it seen a lot in?

A

Idiopathic
Secondary to connective tissue disorders
Lupus, Sjogren, rheumatoid arthritis, scleroderma

22
Q

What are systemic origins of red patches?

A

Haematological diseases
Infectious diseases
Vascular proliferative conditions
Polycythaemia

23
Q

What are local origins of red patches?

A

Haemangioma
Geographic glossitis
Median rhomboid glossitis
Ulcers

24
Q

What is polycythaemia?

A

Increase in RBC in the blood

25
Q

What are the 2 types of polycytheaemia?

A

Relative- same number of RBC, but volume of blood reduced
Absolute- overproduction of RBC

26
Q

What are the 2 types of absolute polycythaemia?

A

Vera- serious
Secondary- In response of stimulus, eg. less oxygen in high altitude environments

27
Q

What can anaemia be due to?

A

Decrease in amount of blood
Decrease in iron
Defective cells
Increase in haemolysis
Decrease in haemopoiesis

28
Q

What does pernicious anaemia cause?

A

Hunter’s glossitis- beefy tongue

29
Q

What is aplastic anaemia?

A

Body stops producing enough new red blood cells.
Platelets will be very deficient so they will have areas of haemorrhage in the soft tissue.

30
Q

What is a haemangioma?

A

Hamartoma- red patches associated with localised proliferation of capillary and cavernous blood vessels.

31
Q

What is a vitropressure test?

A

Press the lesion to see if it goes white, then see if it goes red again.

32
Q

What do you do instead of biopsy for lesions that bleed a lot?

A

Freeze it
Try and produce artificial embolism, eg. polystyrene pellet
Use electric scalpel that coagulates as you cut around or ligate the artery

33
Q

What is median rhomboid glossitis?

A

Lesions present in the midline of dorsal tongue
Candidal hyphae present in many cases- candidosis
Some may have candidal hyphae present in opposite side of the palate

34
Q

What is the histology of median rhomboid glossitis?

A

Lack of filliform papillae
Parakeratinised
Acanthotic epithelium
Neutrophil infiltration
Superficial microabscess formation

Oral candidiasis (18 decks)

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