OD 26 - Developmental Mucosal Conditions Flashcards
What is hairy tongue?
Elongation of filiform papillae on the dorsum of the tongue
What can cause hairy tongue?
Infection Fever Xerostomia Antibiotics and tobacco But can often have no etiological cause/factor
What is the treatment of hairy tongue?
Find and eliminate cause
Reassure
Tongue brush/scrapers
Keratinolytic drugs –> podophyllin 25% in tinture of benzoin
Who is most commonly affected by geographic tongue?
More common in children, but mostly diminishes with age
What causes and is associated with geographic tongue?
CAUSE - obscure
ASSOCIATED WITH
- Pustular psoriasis (most common)
- Allergy
- Juvenile diabetes
- Reiter/Down syndrome
- etcccccc.
What is the definition of geographic tongue?
Depapillation of filiform papillae on the dorsum of the tongue causing erythematous configurations that VARY, forming white margins
What are the symptoms of geographic tongue?
Most asymptomatic
Some have pain/burning
How is geographic tongue diagnosed?
Clinical appearance and history
Confusion/concern = biopsy
What is the treatment of geographic tongue?
Asymptomatic patient = no tx
Symptoms treated with vitamins, mouth rinses, anti-anxiety meds, anti-inflammatory meds (incl. topical and systemic corticosteroids) and anti-fungals
What is median rhomboid glossitits?
Congenital abnormality with red surface in the middle of the dorsum of the tongue
How is median rhomboid glossitits diagnosed?
Clinical appearance and location
Rare for biopsy or candida smear
Who is fissured tongue frequently seen in?
Down syndrome
Melkersson-Rosenthal Syndrome
What are the 3 features seen in Melkersson-Rosenthal Syndrome?
Fissured tongue
Facial nerve paralysis
Chelitis granulomatosa
What is the treatment for median rhomboid glossitits?
None
Short course anti-fungal - esp. if symptoms
What is the diagnosis and treatment of fissured tongue?
Clinical obs and history No tx (reassure pt.)
What is crenated tongue? and who does it present in?
Shallow impressions of the lateral margins of the tongue due to teeth - mucosa normal/red
Frequent in macroglossia, bruxism and chronic anxiety of pushing tongue forward
What is the diagnosis and treatment of crenated tongue?
Clinical obs and history No tx (reassure pt.)
What are fordcyes granules?
Raised yellow/orange spots, heteropic sebaceous glands
Who is likely to have fordcyes granules?
Seen in around 80% of people
Developing in puberty due to sex hormones and becoming more prominent with ageing
What is the diagnosis and treatment of fordcyes granules?
Clinical obs and history No tx (reassure pt.) or laser therapy for cosmetics
What is the clinical presentation of white sponge naevus?
Presents at birth
Asymptomatic, diffuse, bilateral white lesions with shaggy/spongy/wrinkled surface
Usually involving buccal mucosa but sometimes tongue, FOM, pharynx, oesophagus, nose, genital, anus
What are the genetics of white sponge naevus?
Inherited anomaly
Mutations of keratin 13 and 4 - hyperkeratosis
What is the diagnosis and treatment of white sponge naevus?
Clinical and biopsy for conformation
No specific treatment as asymptomatic and behind, however topical tetracycline can be given for cosmetics
What is leukoedema?
Bilateral grey-white diffuse filmy/milky surface with symmetric in distribution and occurring on buccal mucosa (tx=reassurance)
