Mucosa Colour Changes Flashcards
1
Q
Why Oral white lesions occurs?
A
- hereditary: oral spongy nevus
- smoking/ frictional- cause irritation
- Lichen Planus - acanthosis, reduces visibility of epithelial blood flow, increase whiteness of mucosa
1. Lupus erthematous
2. GVHD - candidal leukoplakia
- Carcinoma: thickening of cells
2
Q
Why are white lesions white?
A
- thickening of mucosa/ increase in keratin
- gives less visibility of blood cells in CT beneath
- less BF in tissues
- blanching of tissue
- vasoconstrictor and area becomes white/ pale
3
Q
What is Leukoplakia?
A
- a white patch which cannot be scraped off/ attributed to any other cause
- diagnosis of exclusion
- if due to hyperkeratosis after biopsy, then describe as hyperkeratosis
- 1-5% becomes malignant (higher chance if leukoplakia appears due to betel nut chewing)
4
Q
Fordyce’s spot
A
- ectopic sebaceous glands
- benign
- pt should be reassured
5
Q
Frictional keratosis
A
- rubbing causing thickening of mucosa, keratotic thickening
- traumatic source, parafunctional clench, buccinator muscle contraction
6
Q
Smoker’s keratosis
A
- reactive change
- may have melanin pigment
- 6x more likely to have leukoplakia
- low malignant potential of lesions
- consider the mouth of the pt as a high risk of oral cancer, instead of just the lesion
7
Q
White sponge naevus
A
- hereditary keratosis
- not subject to trauma
- usually start posteriorly
- usually found in other family members too
8
Q
Chemical aspirin burn
A
- damage to epithelial surface
- alendronic acid (osteoporosis) may cause too
- pt may not swallow medication properly
9
Q
Infective Candidosis
A
10
Q
Herpes simplex
A
11
Q
When to refer a white lesion?
A
- most are benign
- if there are red and white, focus on the red
- if lesion is becoming more raised and thickened
- if lesion appears without cause, ie: lateral tongue, anterior floor of mouth, soft palate area
- take photograph with referral
12
Q
Why red lesions red?
A
- blood flow increases due to inflammation/ dysplasia
- reduced thickness of epithelium
13
Q
Why is this concerning?
A
- no obvious reason for this to happen
- papillary haemangioma happening from birth
- dysplasia, increase vascularity and appear much redder
- take biopsy and examine histologically
14
Q
Erythroplakia
A
- atrophic/ non-keratotic end of spectrum
- a red patch which cannot be attributed to any other causes
- more of a concern for malignancy than leukoplakia
- unexplained red change
- requires biopsy
15
Q
Red/Blue lesions
A
- fluid in CT
- dark; slow moving blood; varicosities, veins/ cavernous haemangioma
- light blue; clear fluid, saliva (mucocele), Lymph (Lymphangioma)