Oral lesions X2

Question 1

Leukoplakia risks

Answer 1

tobacco use or alcohol use

- may be seen with some other autoimmune disorders

Question 2

Leukoplakia presentation

Answer 2

usually benign autoimmune but *** is a precancerous lesion> can progress to SCC
- adherent white plaque on mucosa or toungue

Question 3

Leukoplakia Dx/Tx

Answer 3

Biopsy!
Tx: 
1. prevent/ decrease risk of SCC
- avoid tobacco, alch, cheek biting 
2. Refer to ENT If needs removal
3. Monitor closely- change in size of induration

Question 4

Erythroplakia presentation/ Dx

Answer 4

red velvety patch
-on floor of mount toungue pr soft palate
Dx: Biopsy

Question 5

Erythroplakia and risk

Answer 5

Uncommon but ^ risk for malignancy

- with tobacco and alch

Question 6

Oral Hairy Leukoplakia pres/tx

Answer 6

Not malignant
- caused by epstein barr virus 
- immunosup
Present: *verticle corrugates adherent white lesions on lateral surface of the tongue
Tx: usually nothing

Question 7

Oral SCC risks

Answer 7

Tobacco and Alcohol primarily

2nd: UV, radiation, HPV

Question 8

Oral SCC presentation

Answer 8

• Ulcers and masses that do not heal*
• persistant papules, plaques, ulcers, erosion
• dental changes
• dysphagia, sore throat, hoarsness

Question 9

Oral Melanoma

Answer 9

Pigmented oral lesions!
-painless bleeding mass, area of ulceration, discoloration
- 5th-7th decade
Tx: excision with clear margins
eval: for paranasal disease, CT or MRI or PET for matastases

Question 10

Mucoceles Etilogy/ presentation

Answer 10

Minor oral trauma

Pres: pinkish/blue soft papules or nodule

Question 11

Mucoceles Dx/Tx

Answer 11

Dx: clinical
Tx: avoid cheek or lip biting

if sx then can remove with cryotherapy or Co2 laser vaporization

Question 12

Oral SCC Dx/Tx

Answer 12

Dx: Biopsy
Tx: ENT referall, surgical resection, radiation and chemoradiation

Question 13

Coxackie Virus Etiology/ Presentation

Answer 13

Hand foot and mouth
prodrome: not feeling super well
Mouth lesions small apthae- typically spare lips and gingiva
lesions of hands and feet- flat and rim and erythema

Question 14

Oropharyngeal Candidiasis Etiology/ Risks

Answer 14

Thrush- Candida albicans
*opportunisitc infection**
Risk: infancy. immuno comp. DM

Question 15

Oropharyngeal Candidiasis Presentation

Answer 15

Mouth pain
creamy white patches/ plaques with erythemous mucosa
- they wil come off “thrush will brush”

Question 16

Oropharyngeal Candidiasis Dx/Tx

Answer 16

Dx: clinical 
- confirm with JOH 
Tx: topical antifungal: nystatin
clotimazole oropharyngeallozenges 
- clean everything ( toothbrushes, dentures, nipples)

Question 17

Oral Erythema Multiforme Major

Answer 17

Etiology: HSV immune mediated condition
Presentation: target like lesions on the skin with diffuse areas of mucosal erthema painfulerosions or bullae
Dx: clinical
Tx: self limiting
Sx relief
- topical corticosteroid, oral anti-histamines
- if severe use systemic glucocorticoids
** occular involvment refer to opthalmology

Question 18

HSV dx/tx

Answer 18

Viral culture if active lesion

• can do tzanck smear and serology HSV-1
  Tx: oral antiviral (acyclocir, valacyclovir, famciclovir)
  supportive care: analgesics, miracle mouthwash

Question 19

Apthous Ulcers

Answer 19

“canker sores”
Present: shallow. round ulcerative lesions with grayish base and rim of redness

Dx: clinical
Tx: heal on their own and avoid irritating food
oral steroid is hard to use

Question 20

Behcet Syndrome Prese

Answer 20

Recurrent oral and genital ulcers

- painul shallow or deep with central yellowish necrotic base

Question 21

Bechet Synd Dx Tx

Answer 21

Dx: clinical with 3 or more recurrent oral ulcer and ( recurrent genital ulcers, oular , cutanious lesions, or positive pathergy test)
Tx: refer to rheumatology

Question 22

Oral Lichen Planus presentation

Answer 22

Reticular (common)Lace white plaque (wickams striae) on buccal mucosa

erythematous present: red patches often in conjunction ith reticular-painful
Erosive: erosions or ulcers-painful
**increase oral cancer risk

Question 23

Lichen Planus

Answer 23

Dx: Biopsy
Tx: ENT referal
pain relief
topical corticoseroids

Question 24

Black Hairy Toungue q

Answer 24

Benign condition
- abx, candida albiacans, poor hygeine
Prese: elongates filiform papillae
Tx: brush affected area with soft bristle toothbrush

Question 25

geographic Toungue

Answer 25

erythematous patches on doral tongue with circumferential white borders- can change sshape
- usually asymptomatic
Dx: clinical Dx
Tx: reassurance

Question 26

Atrophic glossitis etiology

Answer 26

inflamatory dis that leads to atrophy
- nutritional deficiency
- candida infection 
Pres: smooth glossy erythematous 
- burning sensation and increased sensitivity when eating acidic foods 
Tx: adress underlying condition