common oral dx day 3

Question 1

ACTINIC CHEILITIS/ ACTINIC CHEILOSIS

Answer 1

sun damage to the lips

Question 2

app of actinic chelitis

Answer 2

loss of vermillion border
erythematous areas
small ulcerations/scabs

Question 3

Answer 3

actinic chelitis

Question 4

Answer 4

actinic chelitis

Question 5

why should actinic chelitis be taken seriously?

Answer 5

pre-malignant condition for SCCa

Question 6

pt with hx of actinic chelitis presents with this, palapation is indurated, what might this be?

Answer 6

malignant transformation into SCCa

Question 7

Leukoplakia

Answer 7

• A white patch or plaque that can’t be
  characterized clinically or pathologically
  as any other disease

Question 8

dif dx?

Answer 8

SCCa
hyperkeratosis
hyperplastic candidasis
carcinoma insitu
dysplasia

Question 9

good dif dx for leukoplakias

Answer 9

carcinoma in situ
hyperkeratosis
epithelial dysplasia
SCCa

Question 10

dif?

Answer 10

actually not a leukoplakia= truama from cheek biting (linea alba)

Question 11

Erythroplakia

Answer 11

• A red patch or plaque that can’t be
  characterized clinically or pathologically
  as any other disease.

Question 12

Erythroplakia good dif dx?

Answer 12

epi dysplasia
SCCa
carcinoma in situ

Question 13

Erythroplakia are more likely to be?

Answer 13

cancerous

Question 14

dif?

Answer 14

epi dysplasia
SCCa
carcinoma in situ

Question 15

dif

Answer 15

epi dysplasia
SCCa
carcinoma in situ

Question 16

Ulcer

Answer 16

• A loss of continuity of the epithelium
  that penetrates to the the underlying
  connective tissue

Question 17

indurated ulcer on lat tongue, likely dx?

Answer 17

SCCa, especially with risk factors involved

Question 18

pathologic?

Answer 18

no, physiologic pigmentation

Question 19

where can physiologic pigmentation occur in the oral cavity?

Answer 19

any surface

Question 20

what other conditons can cause oral pigmentation?

Answer 20

addisons, some meds and preutz-jaeger

Question 21

Oral Melanotic Macule
* Focal increase in?
* number of melanocytes?
* most common area?

Answer 21

Macule= only seen not felt
* Focal increase in melanin
* Normal number of melanocytes
* Lower lip vermillion most common

Question 22

Answer 22

oral melanotic macule, does not have ABCDE qualities of melanoma

Question 23

Answer 23

oral melanotic macule

Question 24

oral melanotic macule histo

Answer 24

melanin deposition in basal layer/ lamina propria
normal number melanocytes

Question 25

clinical form lichen planus

Answer 25

reticular and erosive lichen planus

Question 26

most likely? dif?

Answer 26

most likely: reticular lichen planus (wickham striae specific) dif: lichenoid mucositis and allergic rxn

Question 27

Answer 27

erosive lichen planus

Question 28

Reticular Lichen Planus * app/symptoms? * acute or chronic?

Answer 28

* Bilateral asymptomatic white lesions of posterior buccal mucosa (Wickham striae) * Also papules and plaques * chronic condition

Question 29

most likely dx?

Answer 29

reticular LP

Question 30

erosive lichen planus app

Answer 30

ulcerations of the buccal mucosa may or may not possess wickham desquamative gingivitis

Question 31

Likely?

Answer 31

erosive LP

Question 32

likely?

Answer 32

erosive LP?

Question 33

ulcers/wickham on buccal mucosa as well

Answer 33

erosove LP

Question 34

Geographic Tongue additional names

Answer 34

* Benign Migratory Glossitis * Erythema Areata Migrans * Stomatitis Areata Migrans * Wandering Rash of the Tongue

Question 35

geo tongue cause

Answer 35

Cause unknown – Hypersensitivity to environmental factor possibly

Question 36

geo tongue common at?

Answer 36

tip and lat border

Question 37

areas of geo tongue

Answer 37

* Red– Multiple erythematous zones – Atrophy of filliform papillae * White - Elevated, yellow-white, serpiginous border

Question 38

Answer 38

geographic tongue

Question 39

Answer 39

geographic tongue

Question 40

ectopic geo tongue

Answer 40

can occur elsewhere than dorsum of tongue, may occur on the ventral surface with same app of erythmatous areas and white elevated borders

Question 41

Answer 41

ectopic geographic tongue

Question 42

Histopathology: Geographic Tongue

Answer 42

diagnosed from biopsy * Psoriasiform mucositis– Resembles psoriasis * Exocytosis of neutrophils into epithelium= Munro microabscesses

Question 43

biopsy from erythmatous/white lesion of tongue dorsum

Answer 43

geo tongue, PMN in epithelium