final - benign epi lesions

Question 1

most common benign epithelial neoplasm seen intraorally

_associated
_ lesion often found on _

Answer 1

squamous papilloma

HPV 6, 11

solitary lesion - soft palate/uvula or tongue

When they are way back there don’t have the papillary because it is wet and they stick together

Question 2

papillary fronds; usually pedunculated (base narrow) , may be sessile

range of colors (reddish to white) - depending on amount of keratin

Answer 2

squamous papilloma - most common benign neoplasm

Question 3

papillary proliferation of surface epi

often pedunculated but sometimes sessile

variable production of surface keratin

epithelial proliferation supported by finger-like projections of fibrous CT

Answer 3

histology of squamous papilloma

Question 4

Squamous papilloma

tx?
Px? - growth potential? recurrence? malignant transformation?

Answer 4

conservative excision
not really transmissible

Px is excellent ; limited growth potential

recurrences are uncommon, no risk of malignant transformation

Question 5

usually sessile, exophytic, papillary, lesion, often multiple

lesion caused by several strain of human papillomavirus

frequency affecvts children - hands and facial skin (intraoral lesions uncommon)

Answer 5

Verruca Vulgaris - common wart

not so much oral tissue

Question 6

coarse. clumped keratohyaline granules

papillary hyperkeratotic epithelial proliferation

Answer 6

verruca vulgaris - wart

Question 7

Just under superficial keratin

And have koilocytosis -

Tzanck -

Answer 7

koilocytosis - change in cells caused by viral HPV

tzanck - are HSV changes in cells

Question 8

HPV altered cells with perinuclear clearing and small dark nuclei

Answer 8

koilocytosis

tzanch - herpes

Question 9

TX for verruca vulgaris

recur?

Answer 9

spontaneous regression common in kids

excision, cryotherapy liquid N2), keratolytic agents

may recur (squasmous papilloma doesn’t)

Question 10

most contagious and virulence of the HPV’s

caused by several strains of HPV - 6, 11 and (16 and 18 high-risk strains in anogenital lesions)

Answer 10

condyloma acuminatum - venereal wart

spread by direct contact

labial mucosa, soft palate, lingual frenum

Question 11

multiple sessile papules or plaques with a cauliflower like surface

teenagers and young adults

direct contact - like sexual
So if you see it in a young child might need to contact social services

Answer 11

condyloma acuminatum

caused by several strains of HPV - 6, 11 and (16 and 18 high-risk strains in anogenital lesions)

Question 12

papillary epi proliferation with broad, bunted fronds

abundant mitoses; koilocytosis

molecular evidence of HPV

Answer 12

condyloma acuminatum

Question 13

condyloma acuminatum tx

recurrence?

Answer 13

excision, cryotherapy,

laser ablation - may not be safe bc aerozilized

recurrence is common, 30% sometimes multiple episodes

Question 14

squamous papilloma, verruca vulgaris, condyloma acuminatum are all caused by _ etiology

mode of transmission?
clinical presentation?
histo?
rate of recurrence?

Answer 14

HPV

squamous papilloma - unknown, HPV not transmissible, solitary papillary nodule, pap epi proliferation, negative recurrence

verruca vulgaris - direct contact, pap nodule multiple skin, occasionally oral, mild koilocytosis, keratohyalin granules, postive recurrence

condyloma acuminatum - direct contact, multiple oral/genital, broad/blunted from boilocytosis, in-situ HPV DNA. 30% high recurrnece

Question 15

very common benign cutaneous lesion of the epidermal origin

sun exposed surfaces, face, trunk, extremities - areas with numerous sebaceous glands (not palms or soles)

after 40 years of age, may be seen earlier - sun enduced

Answer 15

seborrheic keratosis

benign

Question 16

sharply demarcated, slightly raised plaques - tan brown to nearly black - but homogenous

stuck on appearance - dirty candle wax dripped onto skin, mud thrown against the wall

Answer 16

seborrheic keratosis

40 or after, sun exposure, not on palms or soles, - benign

homogenous in color - but variale

Question 17

composed of basaloid epidermal cells

variable amounts of papillomatosis and keration formation

_ and _ are common - spaces in epi

Answer 17

seborrheic keratosis

horncyst and pseudohorncusts are common - spaces in the epi