Oral lesions X2 Flashcards
Leukoplakia risks
tobacco use or alcohol use
- may be seen with some other autoimmune disorders
Leukoplakia presentation
usually benign autoimmune but *** is a precancerous lesion> can progress to SCC
- adherent white plaque on mucosa or toungue
Leukoplakia Dx/Tx
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
Erythroplakia presentation/ Dx
red velvety patch
-on floor of mount toungue pr soft palate
Dx: Biopsy
Erythroplakia and risk
Uncommon but ^ risk for malignancy
- with tobacco and alch
Oral Hairy Leukoplakia pres/tx
Not malignant - caused by epstein barr virus - immunosup Present: *verticle corrugates adherent white lesions on lateral surface of the tongue Tx: usually nothing
Oral SCC risks
Tobacco and Alcohol primarily
2nd: UV, radiation, HPV
Oral SCC presentation
- Ulcers and masses that do not heal*
- persistant papules, plaques, ulcers, erosion
- dental changes
- dysphagia, sore throat, hoarsness
Oral Melanoma
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
Mucoceles Etilogy/ presentation
Minor oral trauma
Pres: pinkish/blue soft papules or nodule
Mucoceles Dx/Tx
Dx: clinical
Tx: avoid cheek or lip biting
if sx then can remove with cryotherapy or Co2 laser vaporization
Oral SCC Dx/Tx
Dx: Biopsy
Tx: ENT referall, surgical resection, radiation and chemoradiation
Coxackie Virus Etiology/ Presentation
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
Oropharyngeal Candidiasis Etiology/ Risks
Thrush- Candida albicans
*opportunisitc infection**
Risk: infancy. immuno comp. DM
Oropharyngeal Candidiasis Presentation
Mouth pain
creamy white patches/ plaques with erythemous mucosa
- they wil come off “thrush will brush”
Oropharyngeal Candidiasis Dx/Tx
Dx: clinical - confirm with JOH Tx: topical antifungal: nystatin clotimazole oropharyngeallozenges - clean everything ( toothbrushes, dentures, nipples)
Oral Erythema Multiforme Major
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
HSV dx/tx
Viral culture if active lesion
- can do tzanck smear and serology HSV-1
Tx: oral antiviral (acyclocir, valacyclovir, famciclovir)
supportive care: analgesics, miracle mouthwash
Apthous Ulcers
“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
Behcet Syndrome Prese
Recurrent oral and genital ulcers
- painul shallow or deep with central yellowish necrotic base
Bechet Synd Dx Tx
Dx: clinical with 3 or more recurrent oral ulcer and ( recurrent genital ulcers, oular , cutanious lesions, or positive pathergy test)
Tx: refer to rheumatology
Oral Lichen Planus presentation
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
Lichen Planus
Dx: Biopsy
Tx: ENT referal
pain relief
topical corticoseroids
Black Hairy Toungue q
Benign condition
- abx, candida albiacans, poor hygeine
Prese: elongates filiform papillae
Tx: brush affected area with soft bristle toothbrush
geographic Toungue
erythematous patches on doral tongue with circumferential white borders- can change sshape
- usually asymptomatic
Dx: clinical Dx
Tx: reassurance
Atrophic glossitis etiology
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
