OPath III MT Flashcards by Danielle Demian

intradermal nevus

Benign melanocytic lesion. Often notice a decrease in pigmentation as nevi progress from junctional to compound to intradermal.

Tx: none, cosmetic concern only, excise if it causes irritation

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ephilides

“Freckles” Brown pigmentation that develops following sun exposure. More common in children and fair skinned individuals.

Tx: none, encourage limited sun exposure / increased use of sun blocking agents

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Actinic lentigo

Another benign melanocytic lesion. Macular (flat), increase in number in Caucasians with age
“liver spots” appear most often on sun-exposed areas, such as the face, hands, shoulders, and arms

Tx: none, encourage limited sun exposure / increased use of sun blocking agents

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seborrheic keratosis

Benign skin lesion with a “stuck on” appearance. Looks like “dropped on candlewax”.

Tx: none, cosmetic concern only

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dermatosis papulosa nigra

Variant of seborrheic keratoses that occur in African Americans. Usually characterized by multiple, small, hyperpigmented, asymptomatic papules on the face

Tx: none

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actinic keratosis

Precursor lesion for cutaneous squamous cell carcinoma. “Sandpaper” texture

Tx: Either surgical excision or topical, immune-activating agents such as Aldara (2 or 3x weekly for 4-6 weeks, repeated if necessary after 4 week break)
Encourage limited sun exposure/ increased use of sun blocking agents

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telangiectatic capillaries

Prominent vessels, often an indication of sun damage, can also be result of alcohol abuse.

Tx: none, encourage limited sun exposure / increased use of sun blocking agents

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sebaceous hyperplasia

Development of sebaceous glands correlates with puberty. Often seen on forehead, once achieve 1 to 2 mm size, minimal to no further growth.

Tx: none

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basal cell carcinoma

Most common cancer in humans.
Can be pink, brown, or black, shiny, scaly, waxy or hard.
At first, a basal cell carcinoma may appear as a small “pearly” bump that looks like a flesh colored mole or a pimple that doesn’t go away. It may also appear as shiny pink or red patches.

Basal cell carcinomas are fragile and can bleed easily

Tx: biopsy and excise (Moh’s micrographic surgery)

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fordyce granules

Ectopic sebaceous glands. Can be seen anywhere in the mouth, buccal mucosa most common location

Tx: none

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angular cheilitis

Associated with loss of vertical dimension. Candida, some may have co-infection with Candida and Staph.

Tx: clotrimazole 10mg troche PO 5 times daily for 14 days
Nystatin 400,000 units (4-6 mL) PO 6h
soak denture in 10% bleach to water solution for 24hrs
- If external only, can use topical application of
Vytone cream (1% iodoquinol, 1% hydrocortisone).

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regressing HHV-1

Lower lip most common site for recurrent HHV-1.

Tx: topical acyclovir may shorten attacks if applied early

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melanotic macule

Reactive melanosis in response to local trauma

Tx: none, cosmetic concern only

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mucocele

Focal deposition of mucous. Cause is damage to associated minor salivary gland duct.

Tx: conservative excision of duct and associated minor salivary glands.

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leukoedema

Increased water content between epithelial cells.

Tx: none

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linea alba

Found along occlusal plane.

Tx: none

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cheek chewing

Shredded keratin, at a site(s) accessible to teeth.

Tx: suggest pt chew sugarless gum to help with prevention

fibroma

Benign collection of dense fibrous connective tissue.

Tx: Conservative excision.

lichen planus

Immunologically mediated process. Often has “striae” or lacy clinical presentation. Does not wipe off.

Tx: none

maxillary torus

Comprised of dense, vital lamellar bone.

Tx: none, refer to OMFS if removal necessary for denture fabrication

inflammatory papillary hyperplasia

Found under sub-optimally fitting RPD or full denture, may also reflect nearly constant wear.

Tx: conservative excision, new denture.

nicotinic stomatits

Obstruction of minor salivary gland orifices in palate. Most commonly seen in pipe smokers.

Tx: none, suggest smoking cessation

black hairy tongue

overgrowth of chromagenic bacteria and filliform papillae.

Tx: tongue scraper, improve oral hygiene

geographic tongue

patients may be symptomatic e.g. tongue sensitive to spicy or acidic food, when lesions are present.

Tx: none

foliate papilla

part of Waldeyer’s ring. Active lymphoid tissue at posterior lateral tongue. High risk site for squamous cell Tx: none, improve oral hygiene, encourage smoking cessation

mandibular tori

vital lamellar bone Tx: none, refer to OMFS if removal necessary for denture fabrication

amalgam tattoo

silver in amalgam stains reticulin fibers in associated connective tissue. Tx: radiograph to confirm. Follow up, if unusual presentation, may need to excise to rule out melanoma.

parulis

(Aka Sinus Tract) (pl. parulides) rule out an odontogenic source of infection. Tooth vitality testing Tx: endo tx / ext

pericoronitis

Most common in mandibular third molars. Food, etc. gets caught between the overlying soft tissue (operculum) and crown of partially impacted tooth. Tx: Ideally, remove opposing third molars. May need to initially decrease local inflammation e.g. with rinses, then surgery.

acute necrotizing ulcerative gingivitis

Punched out interdental papillae that do not regenerate. Seen in persons with poor oral hygiene and/or poor diet and stress Tx: debridement, improve oral hygiene, alcohol free peridex. - If systemic involvement : Amoxicillin 500mg PO TID for 10d plus Metronidazole 250mg PO TID for 10d OR Clindamycin 300 mg PO TID for 10d

inflammatory fibrous hyperplasia

Associated most often with poorly fitting dentures. Tx: Conservative excision, construct well fitting dentures.

varix

Most often older patients, lower lip frequent site. If thrombosed, will NOT blanch with diascopy. Tx: none

ulcer

Loss of continuity of an epithelial or epidermal covered surface. Tx: should heal in 7-10 days, if not reassess -if larger biopsy (risk of squamous cell)

aphthous ulcer

Immune mediated. Found on freely movable oral mucosa.“Canker sore” laypersons term. Tx: OTC Zilactin for pain

papilloma

Associated with NON-oncogenic human papillomaviruses. Tx: excision

leukoplakia

Rule out dysplasia. White patch that does not rub off. Tx: perform a biopsy to identify exact nature of the lesion.

periapical cyst

Need to do biopsy to confirm. Access vitality of adjacent teeth. Tx: enucleate cyst, endo tx/ ext

dentigerous cyst

Develops due to fluid entrapment between crown of impacted tooth and reduced enamel epithelium. Tx: enucleation and ext of involved tooth. expansile radiolucency : before cutting -palpate, auscultate, aspirate

antral pseudocyst

Collection of fluid below maxillary sinus. Maxillary sinus lining will be superior to the fluid collection. May get referred pain to maxillary teeth with altitudes e.g. during flying Tx: none

condensing osteitis

look for tooth or teeth with pulpal issues in the vicinity Tx: endo tx or ext of involved tooth

exostoses

Bone prominence Tx: none unless removal necessary for denture fabrication

Idiopathic osteosclerosis

Dense vital bone, no identifiable etiology. Tx: none