MOUTH Flashcards
MUCOSAL LESIONS
oral lichen planus
SIGNS & SX: non-erosive lesion, usu painless, vary from lace-like white patches (most common)/papules/streaks on buccal mucosa to erosions on gingival margin. not contagious
ETIOLOGY: unknown, possible drug rxn, Hep C, stress
RED FLAGS: chronic oral lichen planus can inc risk of oral cancer
MUCOSAL LESIONS
leukoplakia
SIGNS & SX: white patches or plaque on the oral mucosa that cannot be rubbed off. Can vary from nonpalpable, faintly translucent white areas to thick, fissured, papillomatous, indurated lesions. Precancerous hyperplasia of the squamous epithelium (20% of lesions progress to CA within 10 yr) OR an inflammatory cond not associated with malignancy
ETIOLOGY: trauma from habitual biting, dentures, tobacco use, infxn, vit deficiency, alcoholism, endocrine disturbances, AIDS
PE: lesion cannot be wiped away with gauze. Check for cercival LA, may indicate malignancy
Dx: biopsy
DDX: “other” white oral lesions that cannot be wiped away
MUCOSAL LESIONS
erythroplakia
SIGNS & SX: red macule or plaque with well-demarcated edges with soft texture; often on the floor of mouth, tongue, palate
ETIOLOGY: unknown, but considered a type of epithelial dysplasia, thus pre-cancerous
Dx: biopsy! CA found in 40% of cases
RISK FACTORS: smoking & alcohol abuse
MUCOSAL LESIONS
oral squamous cell carcinoma (SCC)
SIGNS & SX: may appear as area of erythroplakia or leukoplakia. Exophytic or ulcerative (raised or depressed), rolled border. Early lesion may be asymptomatic, although ulcerated lesions are often painful. Metastatic mass in neck may be first sx.
LOCATION: floor of mouth, or on lateral and ventral surfaces of tongue.
ETIOLOGY: 90% are smoker, alcohol also a risk factor. HPV also associated with SCC
Dx: biopsy
MUCOSAL LESIONS
melanoma
SIGNS & SX: pigmented lesions c concerning signs: asymmetry, irregular borders, variable coloration, increasing diameter; lesion will not blanch
MUCOSAL LESIONS
Fordyce’s Spots
asymptomatic multiple white to yellow papules, often confluent cluster
DDx: Candida albicans- candida wipes off, Fordyce’s don’t!
STOMATITIS
SIGNS & SX: inflammation of oral tissue from local or systemic conditions
ETIOLOGY: infxn from strep, candida, Corynebacterium, syphilis, TB, measles, HIV, HSV, Varicella-zoster virus, fungus
STOMATITIS
oral candidiasis
aka “thrush” or “moniliasis”
SIGNS & SX: slightly raised soft white plaques (look like milk curds) that are easily wiped away, causing bleeding.
ETIOLOGY: common oral yeast infxn caused by Candida albicans, C glabrata, C tropicalis
RISK FACTORS: denture-wearers, diabetics, use of antibiotics, exposure to chemotherapy or radiation, HIV/AIDS, use of inhaled glucocorticoids (asthma), common in infants
DX: confirmed with KOH prep. Recurrent, persistent, extensive disease warrants immune state evaluation
STOMATITIS
pseudomembranous stomatitis
SIGNS & SX: inflammatory rxn that produces a membrane-like exudate. Caused by chemical irritants or bacterial infxn
fever, malaise, and LA may result or it may be localized to the mouth
STOMATITIS
recurrent aphthous stomatitis
“canker sores”
SIGNS & SX: acute, painful, recurring, solitary or multiple necrotizing ulcerations of the oral mucosa. Ulcers are shallow, round to oval with a grayish base and a red border and appear on non-keratinized, moveable mucosa: buccal and labial mucosa Unlike HSV, don’t rupture and crust over
ETIOLOGY: trauma is the most common trigger: toothbrush abrasions, laceration by sharp foods/objects, biting, dental braces, chemical irritants or thermal injury (coffee, tea), foaming agent in toothpaste (sodium lauryl sulfate), stress
DDX: secondary herpetic ulceration- hx of vesicles preceding the ulcers, pemphigus vulgaris
STOMATITIS
herpetic gingivostomatitis
“cold sore” -HSV-1 infxn
SIGNS & SX: often a prodrome of pain, burning, tingling; also fever, malaise, LA, painful eating. Eruption of multiple painful inter-oral vesicular lesions and erosions, erythematous base, crusting. Recurrence is common
STOMATITIS
oral erythema multiforme
SIGNS & SX: sudden onset of painful diffuse hemorrhagic vesicles and bullae with erythematous base, on lips/mucosa. Bullae rupture leaving raw, painful, friable surfaces, then form crusts. Other areas of body- maculopapular erythematous lesions (target lesions) form on hands, arms, feet, legs, face, and neck and, possibly, in the eyes/genitalia
ETIOLOGY: hypersensitivity rxn to HSV, other organisms, drugs, or idiopathic
