Benign Epithelial lesions

Question 1

____________ is the most common benign epithelial neoplasm seen intraorally, HPV-associated (6, 11)

Answer 1

Squamous Papilloma

Question 2

characteristics of Squamous Papilloma:

Answer 2

A) SOLITARY lesion, often found on soft palate/uvula or tongue

B) Papillary fronds; usually pedunculated, may be sessile

C) Range of color (reddish to white)

Question 3

histology of squamous papillomas:

Answer 3

Papillary proliferation of surface epithelium

Often pedunculated but sometimes sessile

Variable production of surface keratin

Question 4

in squamous papilloma lesions, the epithelial proliferation is supported by what?

Answer 4

finger-like projections of fibrous connective tissue

Question 5

what is the treatment/prognosis for Squamous Papilloma?

Answer 5

Conservative excision

Prognosis is excellent; limited growth potential, recurrences are uncommon, no risk of malignant transformation

Question 6

what is the clinical name for the “common wart”?

Answer 6

Verucca vulgaris

Question 7

what causes Verruca Vulgaris? what groups does it usually effect?

Answer 7

Lesion caused by several strains of human papillomavirus

Frequently affects children - hands and facial skin (intraoral lesions uncommon)

Question 8

characteristics of Verucca Vulgaris lesions:

Answer 8

Usually sessile
exophytic
papillary lesion
often MULTIPLE

Question 9

Histological characteristics of Verucca Vulgaris lesions:

Answer 9

Papillary hyperkeratotic epithelial proliferation

Coarse, clumped keratohyaline granules

Koilocytosis – HPV altered cells with perinuclear clearing and small dark nuclei

Question 10

what treatments are available for Verucca Vulgaris (warts)?

Answer 10

spontaneous regression common in kids

excision, cryotherapy, keratolytic agents

may recur

Question 11

______________ are also known as “venereal warts”

Answer 11

Condyloma Acuminatum

Question 12

how are Condyloma Acuminatum acquired? what are their characteristics?

Answer 12

A) spread by direct contact

B) caused by several strains of HPV, including types 6 and 11

C) oral lesions: labial mucosa, soft palate, lingual frenum

Question 13

which strains of HPV are “high risk” and may be present in anogenital Condyloma Acuminatum lesions?

Answer 13

HPV 16 & 18

Question 14

what are the CLINICAL signs of Condyloma Acuminatum?

Answer 14

Clinically present as multiple sessile papules or plaques with a cauliflower-like surface

Usually diagnosed in teenagers and young adults

Question 15

Histology of Condyloma Acuminatum lesions:

Answer 15

papillary epithelial proliferation with broad, blunted fronds

abundant mitoses; koilocytosis

molecular evidence of HPV

Question 16

treatments for Condyloma Acuminatum:

Answer 16

excision, cryotherapy, laser ablation??

recurrence is common - 30% of patients have recurrent lesions after treatment

Question 17

________________ are very common benign cutaneous lesion of epidermal origin. They are found on SUN EXPOSED areas of skin

Answer 17

Seborrheic keratosis

Question 18

Clinical characteristics of Seborrheic keratosis lesions:

Answer 18

• Sun exposed surfaces
• usually seen on the face, trunk or extremities
• areas with numerous sebaceous glands (not palms or soles)

Question 19

what groups are most likely to have Seborrheic Keratosis?

Answer 19

Tendency to develop these lesions after 40 years of age, although may be seen earlier

Question 20

describe the lesions of Seborrheic Keratosis:

Answer 20

Sharply demarcated, slightly raised plaques

Range in color from tan, brown, to nearly black; homogenous

Have a “stuck-on” appearance – “dirty candle wax dripped onto skin” or “mud thrown against a brick wall”

Question 21

Histopathology of Seborrheic Keratosis:

Answer 21

Composed of basaloid epidermal cells

Variable amounts of papillomatosis and keratin formation

Horncysts and pseudohorncysts are common

Question 22

what benign epithelial lesion affects 35% of African-Americans? how is this condition acquired?

Answer 22

Dermatosis papulosa nigra

• Autosomal dominant inheritance

Question 23

when do Dermatosis papulosa nigra lesions appear? what are the physical characteristics of these lesions?

Answer 23

Onset during adolescence

Appear as small (1-2mm diameter), smooth, dark papules located on the face, particularly in the malar region

Question 24

T/F: histopathologically, Dermatosis papulosa nigra lesions present as small seborrheic keratoses

Answer 24

True

Question 25

general characteristics of Sebaceous hyperplasia include:

Answer 25

Relatively common benign process

Most often occurs on the facial skin of middle-aged or older adults

May be solitary or several may develop

Question 26

what are the physical characteristics of Sebaceous Hyperplasia? what other lesions can these be confused with?

Answer 26

umbilicated papule with a yellowish tinge; 1-5 mm in diameter

May be mistaken for basal cell Ca

Question 27

what helpful diagnostic technique can be used for Sebaceous Hyperplasia lesions?

Answer 27

pressure towards the center of the lesion often expresses sebum into the central depression

Question 28

Histological characteristics of Sebaceous hyperplasia:

Answer 28

Multiple hyperplastic lobules of sebaceous gland

Ducts empty into the central depressed area of the lesion

Question 29

what kind of treatment is necessary for Sebaceous Hyperplasia?

Answer 29

none necessary

Simple surgical excision for cosmetic purposes or to R/o basal cell Ca

Prognosis: excellent

Question 30

___________ stomatitis is a Diffuse white appearance of the palatal mucosa; surface may be wrinkly or fissured

Answer 30

Nicotine Stomatitis

Question 31

what are the characteristics of Nicotine Stomatitis lesions?

Answer 31

Elevated papules with punctate red centers

represent inflamed minor salivary gland orifices

Question 32

T/F: Nicotine Stomatitis is caused by the chemical constituents of Tobacco smoke

Answer 32

FALSE

A response to heat generated, rather than chemicals in the tobacco smoke

Question 33

what is the prognosis for Nicotine stomatitis?

Answer 33

excellent; not precancerous

Should resolve within 1-2 weeks of smoking cessation