Mucosal Colour Changes

Question 1

what can cause white lesions

Answer 1

hereditary
smoking/frictional
lichen planus
candida
carcinoma

Question 2

what makes the gingiva pink normally

Answer 2

connective tissue and blood vessels

Question 3

why do lesions appear white

Answer 3

thickening of the mucosa or keratin = less visibility of blood
less blood in tissues = vasoconstrictor

Question 4

what is leukoplakia

Answer 4

a white patch which cannot be scraped off or attributed to any other cause

Question 5

what are fordyce’s spots

Answer 5

ectopic sebaceous glands as oral mucosa forms on skin

Question 6

what percentage of leukoplakia becomes malignant

Answer 6

1-5%

Question 7

how do you treat frictional keratosis

Answer 7

remove the cause

Question 8

how does smoking give keratosis

Answer 8

trauma from thermal gases and reactive change

Question 9

what does hereditary keratosis look like

Answer 9

white sponge naevus

Question 10

what is the pattern of hereditary keratosis

Answer 10

starts in childhood in posterior regions and spreads anteriorly

Question 11

what happens on a cellular level in hereditary keratosis

Answer 11

fluid accumulation between epithelial cells makes it hard to see through epithelium and hard to see blood vessels

Question 12

what happens with an aspirin burn

Answer 12

coagulation of proteins and damage to epithelial surface

Question 13

what is hairy leukoplakia caused by

Answer 13

epstein barr virus

Question 14

what are the types of infective candidosis

Answer 14

acute pseudomembranous
erythematous

Question 15

what does infective herpes simplex look like

Answer 15

intraepithelial vesicles which disrupt the view of blood vessels (white colour) but will burst and lose colour

Question 16

when would you refer a white lesion

Answer 16

if becoming more raised and thickened
if lesion is without cause
lateral tongue
anterior floor of mouth
soft palate

Question 17

why do lesions appear red

Answer 17

blood flow increases causing inflammation and dysplasia
reduced thickness of epithelium

Question 18

what is erythroplakia

Answer 18

atrophic or non-keratotic red patch which cannot be attributed to any other cause

Question 19

what colour of lesion is more of a concern for malignancy

Answer 19

erythroplakia

Question 20

what would a dark red/blue lesion indicate

Answer 20

slow moving blood (vein)

Question 21

what would a light blue lesion indicate

Answer 21

clear fluid like saliva in a mucocele

Question 22

what are the 2 types of haemangioma

Answer 22

capillary and cavernous

Question 23

what would a cavernous haemangioma look like

Answer 23

blue (slow moving blood)

Question 24

what do lymphangiomas look like on a cellular level

Answer 24

proliferation of fluid between spaces

Question 25

what type of connective tissue disease is granulomatosis with polyangiitis (wegners granulomatosis)

Answer 25

small vessel disease

Question 26

what are exogenous causes of mucosal pigmentation

Answer 26

tea/coffee/chlorhexidine/bacterial overgrowth

Question 27

what are the intrinsic causes of mucosal pigmentation

Answer 27

reactive melanosis/melanotic macule
melanocytic naevus
melanoma
effect of systemic disease

Question 28

what is a melanotic macule

Answer 28

increase deposition of pigmentation around melanocyte giving small area of melanin

Question 29

what is melanocytic naevus

Answer 29

manlocyte becoming abnormal and producing too much melanin

Question 30

what can be an intrinsic foreign body

Answer 30

amalgam

Question 31

what can localised brown/black lesions be caused by

Answer 31

amalgam
melanotic macule
melanotic naevus
malignant melanoma
peutz-jehgers syndrome
pigmentary incontinence
kaposi’s sarcoma

Question 32

what can generalised brown/black lesions be caused by

Answer 32

racial
smoking drugs
addisons disease (raised ACTH)

Question 33

what does an amalgam tattoo look like on histology

Answer 33

far apart black dots as it has been phagocytosed and moved elsewhere to be removed by the body

Question 34

what are the characteristic features of mucosal melanoma

Answer 34

variable outline
irregular outline
raised surface
symptomatic (itchy/bleeding)

Question 35

what is the purpose of a biopsy

Answer 35

identify or exclude malignancy
identify dysplasia
identifies other disease e.g., lichen planus

Question 36

what should not be referred to oral med

Answer 36

asymptomatic variations of normal mucosa
benign conditions the practitioner has diagnosed are asymptomatic and do not have malignant risk