common oral dx day 3 Flashcards
ACTINIC CHEILITIS/ ACTINIC CHEILOSIS
sun damage to the lips
app of actinic chelitis
loss of vermillion border
erythematous areas
small ulcerations/scabs
actinic chelitis
actinic chelitis
why should actinic chelitis be taken seriously?
pre-malignant condition for SCCa
pt with hx of actinic chelitis presents with this, palapation is indurated, what might this be?
malignant transformation into SCCa
Leukoplakia
- A white patch or plaque that can’t be
characterized clinically or pathologically
as any other disease
dif dx?
SCCa
hyperkeratosis
hyperplastic candidasis
carcinoma insitu
dysplasia
good dif dx for leukoplakias
carcinoma in situ
hyperkeratosis
epithelial dysplasia
SCCa
dif?
actually not a leukoplakia= truama from cheek biting (linea alba)
Erythroplakia
- A red patch or plaque that can’t be
characterized clinically or pathologically
as any other disease.
Erythroplakia good dif dx?
epi dysplasia
SCCa
carcinoma in situ
Erythroplakia are more likely to be?
cancerous
dif?
epi dysplasia
SCCa
carcinoma in situ
dif
epi dysplasia
SCCa
carcinoma in situ
Ulcer
- A loss of continuity of the epithelium
that penetrates to the the underlying
connective tissue
indurated ulcer on lat tongue, likely dx?
SCCa, especially with risk factors involved
pathologic?
no, physiologic pigmentation
where can physiologic pigmentation occur in the oral cavity?
any surface
what other conditons can cause oral pigmentation?
addisons, some meds and preutz-jaeger
Oral Melanotic Macule
* Focal increase in?
* number of melanocytes?
* most common area?
Macule= only seen not felt
* Focal increase in melanin
* Normal number of melanocytes
* Lower lip vermillion most common
oral melanotic macule, does not have ABCDE qualities of melanoma
oral melanotic macule
oral melanotic macule histo
melanin deposition in basal layer/ lamina propria
normal number melanocytes
clinical form lichen planus
reticular and erosive lichen planus
most likely? dif?
most likely: reticular lichen planus (wickham striae specific)
dif: lichenoid mucositis and allergic rxn
erosive lichen planus
Reticular Lichen Planus
* app/symptoms?
* acute or chronic?
- Bilateral asymptomatic white lesions of posterior buccal mucosa (Wickham striae)
- Also papules and plaques
- chronic condition
most likely dx?
reticular LP
erosive lichen planus app
ulcerations of the buccal mucosa
may or may not possess wickham
desquamative gingivitis
Likely?
erosive LP
likely?
erosive LP?
ulcers/wickham on buccal mucosa as well
erosove LP
Geographic Tongue additional names
- Benign Migratory Glossitis
- Erythema Areata Migrans
- Stomatitis Areata Migrans
- Wandering Rash of the Tongue
geo tongue cause
Cause unknown
– Hypersensitivity to environmental factor possibly
geo tongue common at?
tip and lat border
areas of geo tongue
- Red– Multiple erythematous zones
– Atrophy of filliform papillae - White - Elevated, yellow-white, serpiginous border
geographic tongue
geographic tongue
ectopic geo tongue
can occur elsewhere than dorsum of tongue, may occur on the ventral surface with same app of erythmatous areas and white elevated borders
ectopic geographic tongue
Histopathology: Geographic Tongue
diagnosed from biopsy
* Psoriasiform mucositis– Resembles psoriasis
* Exocytosis of neutrophils into epithelium= Munro microabscesses
biopsy from erythmatous/white lesion of tongue dorsum
geo tongue, PMN in epithelium
