Leukoplakia? (First lecture) Flashcards
white patch of the oral mucosa that cannot be scraped off and connot be dx clinically or microscopically as any other condition
leukoplakia
Is leukoplakia a clinical term?
yes, so it is not a dx
is leukoplakia malignant?
no, it is premalignant
who is at risk of getting leukoplakia?
older adult males (greater than 50)
-ppl that smoke cigs
what are the clinical signs of leukoplakia?
- sharply demarcated white plaque with smooth, verrucous or micronodular surface
- if red component is present - “speckled leukoplakia”
what are the common sites for leukoplakia?
-ventral tongue, FOM, tonsillar pillars
a potent antibiotic that caused leukoplakia?
sanguinaria-associated leukoplakia
-occurs when pts use Viadent toothpaste or mouthwash
where does anguinaria - associated leukoplakia usually affect?
max buccal gingiva and vestibule
what is seen histopathologically with sanguinaria - associated leukoplakia?
epithelial atypia or mild dysplasia
what is seen histopathologically for all types of leukoplakia?
- some degree of hyperkeratosis (wet keratin appears white)
- often sharpley demarcated from normal epi
- precancerous changes may be evident microscopicallly (epitherlial dysplasia)
- mild, moderate, severe dysplasia or carcinoma-in-situ
what is the tx for leukoplakia?
- controversial
- for no dyplasia/mild = watch and wait
- for moderate dyplasia = remove by the most convienient means available
what is the px of leukoplakia?
- GUARDED
- 15% of non-dyplastic lesions will transform if not tx
- 33% of dysplasic lesions will transform
- 30% of leukoplakias will recur
a red patch that cannot be dx as an other condition clinically or microscopically
erythroplakia
is erythroplakia or leukoplakia more serious?
erythroplakia
what are the clinical signs of erythroplakia?
velvety-red, well-demarcated patch, usually affecting the lateral tongue, FOM, or soft palate
microscopically, what does erythroplakia look like?
90% of these lesions are severe epi dysplasia or worse at the time of biopsy
why does erythroplakia appear red?
lack of keratin production on the surface of the lesion
which is more advance when initially detected, leukoplakia or erythroplakia?
erythroplakia
what is the tx and px of erythroplakia?
same as leukoplakia if it has a similar degree of epithelial dysplasia
premalignant sun-induced skin lesion
actinic keratosis
where are the common sites for actinic keratosis?
- facial skin
- vermillion zone of the lips in fair-skinned persons over 40 years of age
what causes actinic keratosis?
ultraviolet light exposure
what is the clinical appearance of actinic keratosis?
scaly plaque with sandpaper texture
what are the histological findings of actinic keratosis?
- hyperkeratosis, usually perakeratin
- some degree of epi dysplasia or even superficially invasive squamous cell carcinoma in situ
what is the tx for actinic keratosis of the skin?
- topical liquid nitrogen
- surgical excision
- laser ablation
- effudex
- aldara
what is the px for actinic keratosis?
fair - good
-pts must be monitored for development of new lesions though
term for actinic keratosis involving the vermillion zone of the lower lip
actinic cheilosis (cheilitis)
what are the clinical signs of actinic cheilosis?
chronic scaling, crusting, ulceration and/or fissuring of the lip may be seen
what is the tx of actinic cheilosis?
vermillionectomy with advancement of the labial mucosa or laser ablation of the involved vermillion zone
