Mucosal Colour Changes Flashcards
what can cause white lesions
hereditary
smoking/frictional
lichen planus
candida
carcinoma
what makes the gingiva pink normally
connective tissue and blood vessels
why do lesions appear white
thickening of the mucosa or keratin = less visibility of blood
less blood in tissues = vasoconstrictor
what is leukoplakia
a white patch which cannot be scraped off or attributed to any other cause
what are fordyce’s spots
ectopic sebaceous glands as oral mucosa forms on skin
what percentage of leukoplakia becomes malignant
1-5%
how do you treat frictional keratosis
remove the cause
how does smoking give keratosis
trauma from thermal gases and reactive change
what does hereditary keratosis look like
white sponge naevus
what is the pattern of hereditary keratosis
starts in childhood in posterior regions and spreads anteriorly
what happens on a cellular level in hereditary keratosis
fluid accumulation between epithelial cells makes it hard to see through epithelium and hard to see blood vessels
what happens with an aspirin burn
coagulation of proteins and damage to epithelial surface
what is hairy leukoplakia caused by
epstein barr virus
what are the types of infective candidosis
acute pseudomembranous
erythematous
what does infective herpes simplex look like
intraepithelial vesicles which disrupt the view of blood vessels (white colour) but will burst and lose colour
when would you refer a white lesion
if becoming more raised and thickened
if lesion is without cause
lateral tongue
anterior floor of mouth
soft palate
why do lesions appear red
blood flow increases causing inflammation and dysplasia
reduced thickness of epithelium
what is erythroplakia
atrophic or non-keratotic red patch which cannot be attributed to any other cause
what colour of lesion is more of a concern for malignancy
erythroplakia
what would a dark red/blue lesion indicate
slow moving blood (vein)
what would a light blue lesion indicate
clear fluid like saliva in a mucocele
what are the 2 types of haemangioma
capillary and cavernous
what would a cavernous haemangioma look like
blue (slow moving blood)
what do lymphangiomas look like on a cellular level
proliferation of fluid between spaces
what type of connective tissue disease is granulomatosis with polyangiitis (wegners granulomatosis)
small vessel disease
what are exogenous causes of mucosal pigmentation
tea/coffee/chlorhexidine/bacterial overgrowth
what are the intrinsic causes of mucosal pigmentation
reactive melanosis/melanotic macule
melanocytic naevus
melanoma
effect of systemic disease
what is a melanotic macule
increase deposition of pigmentation around melanocyte giving small area of melanin
what is melanocytic naevus
manlocyte becoming abnormal and producing too much melanin
what can be an intrinsic foreign body
amalgam
what can localised brown/black lesions be caused by
amalgam
melanotic macule
melanotic naevus
malignant melanoma
peutz-jehgers syndrome
pigmentary incontinence
kaposi’s sarcoma
what can generalised brown/black lesions be caused by
racial
smoking drugs
addisons disease (raised ACTH)
what does an amalgam tattoo look like on histology
far apart black dots as it has been phagocytosed and moved elsewhere to be removed by the body
what are the characteristic features of mucosal melanoma
variable outline
irregular outline
raised surface
symptomatic (itchy/bleeding)
what is the purpose of a biopsy
identify or exclude malignancy
identify dysplasia
identifies other disease e.g., lichen planus
what should not be referred to oral med
asymptomatic variations of normal mucosa
benign conditions the practitioner has diagnosed are asymptomatic and do not have malignant risk
