[Intro to Oral Medicine] White & Red Patches Flashcards
what are all the things that contribute to the colour of the oral mucosa?
vascularity
keratin
epithelial thickness
candida
melanin
inflammation
what are white patches usually a sign of?
Abnormal/increased keratin
Increased epithelial thickness
Possibly candida?
KERATOTIC TISSUE CANNOT BE WIPED AWAY
what would put a pt at increased risk of oral candidiasis?
immunocompromised (medication or medical condition)
dentures (porosity of acrylic)
smoking
rinse after inhaler use
inhaler use (corticosteroid is immunosuppressive allowing candida to grow)
what are management methods for oral candidiasis?
antifungal therapy (fluconazole, miconazole, nystatin)
local measures:
rinse after inhalers
use spacer
denture hygiene
smoking cessation
what is oral lichen planus?
chronic inflammatory condition,
destruction of basal keratinocytes
may be asymptomatic or present as burning/stinging
what is an oral lichenoid reaction?
similar appearance to ORAL LICHEN PLANUS BUT typically a REACTION to trigger medicines or materials
what drugs can cause oral lichenoid reactions?
antihypertensives, antimalarials, NSAIDs, Lithium, Allopurinol
What materials can cause oral lichenoid reactions?
metals like gold & nickel
amalgam restorations
how do you manage oral lichen planus or reactions?
simple mouthwash
LA (benzydamine spray)
avoid trigger factors (Spicy/fizzy stuff)
steroid mouthwash (betamethasone mw)
change amalgam restorations?
onward referral for biopsy, inform pt of increased cancer risk. Trying to stop the cause in lichenoid reaction is important
what is leukoplakia?
characterised by thickness of keratin resulting in a white patchy appearance.
NO OBVIOUS CAUSE - Diagnosis through exclusion
has potential to be malignant and requires a biopsy for histological examination
what causes red patches?
atrophy (tissue becomes thinner)
inflammation
*red patch with no clear cause has high chance of being dysplastic/malignant
what is granulomatosis with polyangiitis?
rare autoimmune disease that affect blood vessels (Systemic vasculitis) and the formation of granulomas
can be associated with fever & weight loss.
Immunosuppressants to manage
what is erythroplakia?
velvety/firey, red patch
diagnosis of EXCLUSION
most will have dysplasia or malignancy
urgent referral indicated
what is orofacial granulomatous disease?
OFG:
chronic inflammatory disorder resulting in granuloma (accumulation of immune cells) formation affecting soft tissues of oral cavity
what is oral crohns?
type of inflammatory bowel disease affecting digestive tract from mouth all the way to anus.
