OPMDs Flashcards
What clinical parameters can be used to evaluate possibility of malignant transformation?
size, site, homogeneity, multifocality, duration, dysplasia, smoking habit, drinking habit
Homogenous lesion
Uniform colour, flat, thin, without or with slightly corrugated surface
What types of non-homogenous lesions are there?
Speckled, nodular, verrucous, mixed
What is KUS (keratosis of unknown significance)?
keratotic lesion that pathologists and researchers recognize and label “hyperkeratosis”, which is histopathologically somewhat different from frictional and reactive keratosis and are not obviously dysplastic
Why may the term “KUS” be more appropriate than “benign hyperkeratosis”
Because the significance is unknown, some may be reactive and some may progress to dysplasia and OSCC
Why may the term “proliferative leukoplakia” be more appropriate than “proliferative verrucous leukoplakia”?
because approximately 18% are fissured and 22% erythematous (not all lesions are verrucous)
What may KUS show on a biopsy/
Hyperkaratosis, parakeratosis, epithelial atrophy or acanthosis with or without inflammation
If biopsy shows severe dysplasia or carcinoma in situ what should be done to the lesion?
Excised
If biopsy shows mild to moderate dysplasia what should be done?
Observed if its felt that completely removing area not possible because of extent or location of lesion. However if area discrete excision can be attempted
Non surgical interventions for treating leukoplakia to prevent oral cancer
-Vitamin A/Retinoids,
- Beta carotene or carotenoids
- NSAIDS (specifically ketorolac and celecoxib)
- Herbal extracts (inc tea components, herbal
mixture, freeze dried black raspberry gel)
- Bleomycin
- Bowman-birk inhibitor
Erythroplakia
A fiery red patch that cannot be characterized clinically or pathologically as any other definable disease
Lichen planus
Chronic inflammatory mucocutaneous immuno-mediated disorder of unknown aetiology, in which T lymphocytes accumulate beneath the epithelium of the oral mucosa and increase the rate of differentiation of stratified squamous epithelium, resulting in hyperkeratosis and erythema with or without ulceration.
Prevalence of lichen planus in population
1-2%
White papules that coalesce to form a reticular, annular (Wickham’s striae) or plaque-like pattern
Erythema, erosion and ulceration can also occur, often in association with white striae
- What lesion/condition would this be?
Lichen planus
Oral sites involved in lichen planus
- Commonly, buccal mucosa bilaterally, the borders and dorsum of the tongue and gingiva
- Palate (hard or soft), lips, and floor of mouth less commonly affected
