Clinical Ddx Flashcards
Mucosal changes
Blue/purple lesions
- Mucocele
- Salivary gland tumor
- Gingival cyst
- Melanoma
- Kaposi sarcoma
- Varix
Mucosal changes
Cobblestone pattern
- Crohn’s
- Heck’s
- Darier’s
Mucosal changes
Pigmented lesions (single):
- Amalgam tattoo
- Melanotic macule
- Melanoma
- Nevus
- Melanoacanthoma
Mucosal changes
Pigmented lesions (multiple/diffuse):
- Racial pigmentation
- Smoker’s melanosis
- Drug-‐induced pigmentation
- Melanoacanthoma
- Peutz-‐Jeghers
- Addison’s disease
- Heavy metal intoxication
Mucosal changes
Red lesion
- Erythroplakia
- Candidiasis
- Burn
- Hemangioma
- Mucositis
- Lupus
Mucosal changes
Red/white mixed lesions
- Candidiasis
- Lichen planus
- Lupus
- Erythroleukoplakia
- Burn
- Cinnamon reaction
Mucosal changes
Telangiectasias:
- Hereditary hemorrhagic telangiectasias (Osler-‐Weber-‐Rendu syndrome)
- CREST syndrome
- Primary biliary cirrhosis
Mucosal changes
Ulceration (single)
- Traumatic ulcer
- Apthous ulcer
- Tuberculosis
- Leprosy
- Deep fungal infection
- Squamous cell carcinoma
- Wegener’s
- Syphilis
- Chron’s
Mucosal changes
Ulceration (multiple)
- Aphthae
- Inflammatory bowel disease: Chron’s and ulcerative colitis
- Celiac disease
- Behcet’s disease
- Reiter’s syndrome
- MAGIC syndrome
- Sweet’s syndrome
- PFAPA (periodic fever, aphthous ulcers, pharyngitis, cervical adenitis)
- Heavy metal intoxication (lead, mercury, arsenic, gold)
- Blood dyscrasias (neutropenia, agranulocytosis, cyclic neutropenia, aplastic anemia, leukemia)
- Lack of nutrients (iron, folate, vit B, zinc)
- Vesiculo-‐bullous and AI (pemphigus, pemphigoid, ELP, EM)
- Mucositis (CT and RT)
- GVHD
Mucosal changes
Warty Lesions:
- Papilloma
- Verruca vulgaris
- Condyloma acuminatum
- Heck’s Disease
- Condyloma lata
- Verruciform leukoplakia
- Verrucous carcinoma
- Verruciform xanthoma
- Giant cell fibroma
- Warty dyskeratoma/Darier’s disease
- Acanthosis nigricans
- Ductal papillomas
Mucosal changes
White lesion:
- Candidiasis
- Leukoplakia (Hyperkeratosis, dysplasia, carcinoma)
- Morsicatio
- Thermal/Chemical burn
- Lichen planus
- Lupus
- Genodermatoses (White sponge nevus, HBID, pachyonychia congenita I, dyskeratosis congenita)
- Uremic stomatitis
Mucosal changes
Yellow lesions
- Parulis
- Lymphoepithelial cyst
- Lymphoid aggregate
- Granular cell tumor
- Lipoma
- Verruciform xanthoma
- Pyostomatitis vegetans (snail track ulceration)
Floor of mouth
Nodule:
- Ranula
- Lymphoepithelial cyst
- Dermoid cyst
- Salivary gland tumors
- Mesenchymal tumor
Gingiva
Desquamative Gingivitis:
- Lichen planus
- Pemphigoid
- Pemphigus vulgaris
- Linear IgA disease
- Epidermolysis bullosa
- Lupus erytematosus
- Chronic ulcerative stomatitis
- Paraneoplastic pemphigus
Gingiva
Gingival hemorrhage
- Gingivitis
- Hemophilia
- Thrombocytopenia
- Leukemia
- Chemotherapy
Gingiva
Gingival enlargement:
- Hyperplastic gingivitis
- Gingival fibromatosis/Familial gingival fibromatosis
- Juvenile hyaline fibromatosis
- Drug induced: cyclosporine, phenytoin and nifedipine
- Plasma cell gingivitis
- Leukemia
- Scurvy
- Wegener’s granulomatosis (strawberry gingivitis)
- Cinnamon stomatitis
- Diabetes
- Blood dyscrasias
Gingiva
Gingival nodules:
- Fibroma
- 3P’s (pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell lesion)
- Mesenchymal (neurofibroma, lipoma, etc)
- Squamous cell carcinoma (~ PG)
- Kaposi sarcoma
- Odontogenic tumors/cysts (eruption cyst, gingival cyst, Gorlin cyst, ameloblastoma)
- Metastatic tumors
Gingiva
Necrotizing gingivitis
- NUG
- Primary herpes (affects also ST, such as tongue, lips)
- Gonorrhea (no odor)
- Mononucleosis
- Measles (if pt is malnourished)
- Agranulocytosis (pt under CT)
Tongue
Dorsal tongue bumps
- Fibroma
- Granular Cell Tumor
- Mesenchymal Tumors
- Lingual thyroid
- Enlarged Circumvallate Papilla
- Osseous choristoma
- Lipoma
Tongue
Fissured tongue
- Melkerson-‐Rosenthal syndrome
- Down syndrome
- Sjogren syndrome
- Psoriasis
- Geographic tongue
Tongue
Loss of papillae
- Candidiasis
- Anemia
- Vitamin B deficiency
- Iron deficiency
Tongue
Macroglossia:
- Hemangiona/Lymphangioma/Vascular malformation
- Beckwith-‐Wiedemann syndrome
- Down’s syndrome
- Neurofibromatosis
- MEN 2B
- Mucopolysaccharidoses
- Hemihyperplasia
- Cretinism
- Amyloidosis
- Acromegaly
- Angioedema
- Myxedema
- Carcinomas or other tumors
- Edentulism
Tongue
Nodules:
- Lymphangioma
- Lingual thyroid
- Mesenchymal (neuroma, neurofibroma, traumatic neuroma)
- Cartilage/bone choristoma
- Amyloidosis
- Granular cell tumor
- Pyogenic granuloma
- Fibroma
Palate
Newborns:
- Gingival cysts (more in MX alveolar process)
- Palatal cysts (Epstein pearls-‐midline; Bohn’s nodules-‐scattered)
- Congenital epulis
- Melanotic neuroectodermal tumor of infancy
Palate
Deep palatal ulcerations:
- Nasal NK/T cell lymphoma
- Syphilis
- Mucormycosis (aka zygomycosis, phycomycosis)
- Wegener’s
- Cocaine use - drug-induced palatal perforation
- Leprosy
- Necrotizing ulcerative mucositis
Palate
Masses:
- Fibrous dysplasia
- Segmental odontomaxillary dysplasia
- Lymphoma
- Abscess
- Nasopalatine duct cyst (anterior)
- Salivary gland tumor
- Renal osteodystrophy-‐ the mass is a brown tumor
- Kaposi sarcoma
Palate
Petecchiae/Ecchymosis
- Scarlet fever
- Mononucleosis
- Blood dyscrasias (thrombocytopenia, anemia)
- Trauma (felatio, coughing, vomiting, convulsions, giving birth, increased thoracic pressure)
- Upper respiratory tract infections
- Hemophilia
Lip
Ulceration and crusts:
- Trauma (mechanical, chemical, electrical)
- Erythema multiforme
- Actinic cheilits
- Squamous cell carcinoma
- Exfoliative cheilitis
- Cheilocandidiasis
- Cheilitis glandularis
Lip
…involving perioral skin:
- Cheilocandidiasis
- Circumoral dermatitis
- Perioral dermatitis
- Impetigo
- Sialorrhea
Lip
Vesicles
- Herpes simplex
- Varicella
- Herpes zoster
- Impetigo
Lip
Nodule:
Upper lip-‐
- Nasolabial cyst
- Fibroma
- Salivary gland tumor (canalicular >40; PA <40)
- Mesenchymal (Hemangioma, NF, lipoma)
Lip
Nodule:
Lower lip
- Mucocele
- SCC/ KA
- Fibroma
- Mesenchymal (Hemangioma, NF, lipoma (most common))
Childhood/newborn lesions
- Congenital epulis of the newborn
- Melanotic neuroectodermal tumor of infancy
- Ameloblastic fibroma/fibro-‐odontoma
- Cystic hygroma
- Cherubism
- Hemangioma
- Eruption cyst
- Palatal cysts of the newborn
- Teratoma
Extraction site growths
- Epulis Granulomatosa
- Pulse Granuloma
- Mylospherulosis
- Ameloblastoma
- Mets
Extraoral
Epidermoid cysts:
- Gardner syndrome
- Nevoid basal cell carcinoma syndrome
Extraoral
Erythema nodosum
- Valley fever (coccidioidomycosis and erythema nodosum)
- Sarcoidosis
- Lofgren’s syndrome
- Behçet syndrome
-TB?
Facial paralysis:
- Bell’s palsy (idiopathic)
- Melkersson-‐Rosenthal Syndrome
- Heerfordt’s Syndrome
- Ramsay-‐Hunt Syndrome
- Multiple sclerosis
- Guillan-‐Barre syndrome
- Sarcoidosis
- Lyme disease
- Wegener’s
- Leprosy
- Osteopetrosis
Frontal bossing:
- Gorlin syndrome
- Osteopetrosis
- Crouzon
- Cleidocranial dysplasia
- Acromegaly
Intestinal polyps
- Cowden (most are benign)
- Peutz-‐Jeghers (most are benign)
- Gardner syndrome (most are malignant)
Increased cancer susceptibility
- Xeroderma pigmentosum (BCC, SCC)
- Papillon-‐Lefreve
- Plummer Vinson
- Gorlin syndrome
- Peutz-‐Jeghers (GI carcinoma, breast cancer)
- Cowden’s
- Gardner
- Acanthosis nigricans
- Recessive dystrophic epidermolysis bullosa (SCC)
- Immunosuppressed patients (AIDS, transplant)