Elementary and benign oral lesions

Question 1

Papula

Answer 1

Characterized by a superficial, elevated, solid, circumscribed lesion that is usually less than 10 x 5mm in diameter and may be of any colour (e.g. oral lichen planus or fordyce granule). Can coalesce and form a plaque

Question 2

Plaque

Answer 2

Characterized by a superficial, slightly raised, circumscribed lesion. Its diameter can be greater than 5mm or 10mm, based on different definitions. Can be formed by multiple papules coalescence (e.g. leukoplakia)

Question 3

Types of secondary elementary lesions

Answer 3

Atrophy, erosion, ulcer, fissure,, crust, scar

Question 4

Types of primary elementary lesions

Answer 4

Papula, plaque, macule/patch, nodule, vesicle/bulla,, petechia/ecchymosis

Question 5

Atrophy

Answer 5

Reduction of epithelial thickness, with flattening of the basal layer and disappearance of the inter-papillary epithelium and with reduced cell volume, generally related to dystrophic phenomena (aging, fungal infections, drug-related, nutritional deficiency)

Question 6

Erosion

Answer 6

Clinically characterized by a red, shallow, moist, slightly depressed lesion due to a loss of epithelium without damage to the basement membrane zone.

Question 7

Do erosions result in scar formation?

Answer 7

No (because no damage to basement membrane)

Question 8

Ulcer

Answer 8

Clinically characterized by loss of continuity of the epithelium with damage to the basement membrane zone and possible scar formation. The centre of the lesion is initially red and then turns grey-white-yellowish after being covered with fibrin clot. The periphery of the lesion may be erythematous or keratotic.

Question 9

What parameters are important for evaluation of an ulcer?

Answer 9

Site, number, size, shape, part of an ulcer

Question 10

What are the benign lesions of oral mucosa of epithelial origin?

Answer 10

Papilloma, drug induced gingival overgrowth

Question 11

What are the benign lesions of oral mucosa of lamina propria origin

Answer 11

Traumatic fibroma, pyogenic granuloma, peripheral giant cell granuloma, mucocele, lipoma, hemangioma

Question 12

What benign lesion can be caused by HPV

Answer 12

Papilloma

Question 13

What medications can cause drug induced gingival overgrowth?

Answer 13

Anticonvulsants, immunosuppressants, Ca channel blockers

Question 14

Where do aphthous ulcers usually appear in RAS?

Answer 14

Non-keratinized oral mucosa of the lips, buccal mucosa and tongue. Occasionally the lesions may also be observed on strongly keratinized palatal and gingival mucosa.

Question 15

3 types of aphthous ulcer

Answer 15

Minor (5-10mm), major (>10mm), herpetiform (<5mm)

Question 16

Which aphthous ulcer is deep?

Answer 16

Herpetiform

Question 17

What topical treatment can be used for aphthous ulcers?

Answer 17

Chlorhexidine, minocycline, dexamethasone ointment