Colors of Oral Pathology II Flashcards
what is the “white” form of candidiasis?
pseudomembranous candidiasis
what is the “red” form of candidiasis, and what are the sub-categories?
- erythematous candidiasis
- central papillary atrophy of the tongue (median rhomboid glossitis)
- angular cheilitis
- denture stomatitis
what are basic forms that antifungals come in?
rinse, troche (dissolvable tablet - don’t want to use with patients with xerostomia), tablet, cream/ointment
- *need histo to diagnose*
- denture stomatitis (erythematous candidiasis)
- or hypersensitivity reaction
central papillary atrophy of the tongue aka median rhomboid glossitis (form of erythematous candidiasis)
angular cheilitis (form of erythematous candidiasis)
angular cheilitis (form of erythematous candidiasis)
what is another term for angular cheilitis?
perleche
what two things cause angular cheilitis?
reduced vertical dimension and salivary pooling
what are the basic treatment options for angular cheilitis?
- antifungals
- increase vertical dimension
what are antifungal prescription options for the treatment of angular cheilitis?
- mycolog II (triamcinolone 0.1% and nystatin 100,000 gram ointment)
- nystatin oral suspension (100,000 units/ml) aka mycostatin
- clotrimazole troche 10mg aka mycelex
what is the prescription for mycolog II?
- aka triamcinolone 0.1% and nystatin 100,000 units/gram ointment
- disp: 15g tube
- sig: apply tid until healing occurs
- refills: 1
what is the prescription for nystatin oral suspension (100,000 units/ml)?
- aka mycostatin
- disp: 240ml
- sig: rinse with 1-2tsp for 2 min then expectorate (or swallow, if affecting the soft pharynx)
- refills: 3
what is the prescription for clotrimazole troche 10mg?
- aka mycelex
- disp: 50 tabs
- sig: one troche 5 times a day (let dissolve in mouth)
- refills: 0
lymphoid hyperplasia (on floor of mouth because of waldeyer’s ring)
lymphoid hyperplasia
clinically blanches under pressure
hemangioma
clinically blanches under pressure
hemangioma
a ___ is a benign proliferation of blood vessels
hemangioma
hemangiomas affect ___% of children
10-12%
how is a hemangioma differentiated from a hematoma/petechiae?
a hemangioma will clinically blanch under pressure (dyoscopy)
what is the treatment for hemangioma?
surgery, laser, observation
history of placing candies in this area
hypersensitivity reaction
history of eating a scalding hot slice of deep dish pizza
thermal burn
what is the definition of erythroplakia?
a pathologic intraoral red patch that cannot be clinically diagnosed as any other entity
what are the most common locations of erythroplakia?
- floor of mouth
- tongue
- soft palate
90% of erythroplakia lesions are histologically ___, ___, or ___
- severe dysplasia
- carcinoma in situ
- squamous cell carcinoma
what are 6 red lesions?
- erythematous candidiasis
- angular cheilitis
- lingual tonsil
- hemangioma
- hypersensitivity reaction
- erythroplakia
physiologic pigmentation
radiograph shows radiopacities in the area of the lesion
amalgam tattoo
oral melanotic macule
oral melanotic macule
what is another name for an oral melanotic macule?
focal melanosis
___ is a solitary, well-demarcated tan to dark brown macule, 1-7mm in size
oral melanotic macule
what are the most common locations for oral melanotic macules?
lower lip > buccal mucosa > gingiva
what is the treatment for oral melanotic macule?
none, or biopsy to rule out melanoma
intradermal nevus
if this was found within the oral cavity, it would be considered an intramucosal nevus
an intramucosal nevus is histologically identical to a ___
intradermal nevus
intramucosal nevus
oral melanoacanthoma
oral melanoacanthoma is an aquired ___
pigmentation
oral melanoacanthoma is seen almost exclusively in what population?
african americans (more common in females, age 20-30)
what is the most common site of occurence of oral melanoacanthoma?
buccal mucosa
what is the treatment for oral melanoacanthoma?
- lesions tend to increase rapidly in size
- incisional biopsy is indicated to rule out melanoma
- no further treatment is necessary, as lesions can regress after incisional biopsy
melanoma
melanoma
melanoma
melanoma
melanoma
melanoma
malignant melanoma is ___ with early ___
rapidly growing with early metastasis
if you have median rhomboid glossitis with any other form of candidiasis, you have ___
chronic multifocal candidiasis
blue nevus
lingual varicosities
hemangioma
ranula
salivary duct cyst
mucoepidermoid carcinoma
fordyce granules
oral lymphoepidermoid cyst
parulis aka gum boil
lipoma
lipoma
lipoma
granular cell tumor
___ is a benign soft tissue neoplasm that shows a predilection for the oral cavity
granular cell tumro
what is the most common site for a granular cell tumor?
tongue (up to 50%) - dorsal surface
are granular cell tumors symtomatic or asymptomatic? sessile or pedunculated? what size?
asymptomatic, sessile nodule that is less than 2cm
what color are granular cell tumors typically?
yellow or mucosal-colored
___ patients may experience multiple granular cell tumors
african american
xerostomia
xerostomia
what are two treatments for xerostomia?
biotene products and mouth kote
what are the 6 steps of xerostomia therapy?
- sip water throughout the day
- suck on ice (do not chew)
- discontinue alcohol, caffeine, soda
- humidifier at night
- lubricate lips (lanolin)
- fluoride supplementation
what is pilocarpine?
prescription approved for the treatment of dry mouth from radiation/chemotherapy, sjogren’s syndrome
what is the prescription for pilocarpine?
- pilocarpine 5mg tablets
- aka salagen
- disp: 90 tablets
- sig: 5mg TID for first month and then titrating to maximum dose of 30mg per day depending upon response and tolerance
what medications counteract pilocarpine?
meds with anticholinergic effects, like benadryl and some antidepressants
what are some options to treat dry lips?
- chapstick (plain)
- aquaphor
- blistex complete
- landolin
what are 3 prescriptions for herpetic infections?
- acyclovir 5% ointment (zovirax)
- famcyclovir (famvir) 125mg tablets
- valacyclovir (valtrex) 500mg tablets
what is the prescription for acyclovir 5% ointment (zovirax)?
- disp: 3 or 15mg tube
- sig: apply to affected area six (6) times a day
what is the prescription for famcyclovir (famvir) 125mg tablets?
- disp: 10 tablets
- sig: take one tablet bid for five (5) days
what is the prescription for valacyclovir (valtrex) 500mg tablets?
- disp: 8 tablets
- sig: take four (4) tablets in prodrome and four (4) tablets 12 hours later
what is L-lysine used for?
over-the-counter medication for herpetic infections
what are the directions for L-lysine use for herpetic infections?
- L-lysine 500mg tablets
- take 1 tablet daily
- at start of outbreak, take ten (10) tablets through outbreak, then go back to 1 tablet daily
what is abreva?
- aka docosanol 10% cream
- non-prescription product used for herpetic infections
- comes in a 2g tube
- a thin amount is applied to the affected area five (5) times a day
what are the 9 steps to treating burning mouth?
- lubrication
- candidiasis treatment
- nutritional treatment (B12, folate, iron, zinc)
- diabetic control
- eliminate triclosan/tartar control products
- switch hypertensive medication if on ACE-inhibitor
- clonazepan 0.5mg tablet: start with dissolving half a 0.5mg tab bid and slowly increase to 1mg bid (2 tabs) **off label usage**
- alpha lipoid acid
- capsaicin
