oral mucosal colour changes Flashcards
reasons for oral white lesions
hereditary
smoking/frictional
lichen planus
candida leukoplakia
carcinoma
hereditary white lesion
oral white sponge navus
produces characteristic mucosa which is related to genetic changes to cytokeratin’s in the mouth
how does smoking cause white lesions
irritation to mucosal surface causing thickening of keratin layer on surface which obtructs view to blood vessels on the tissues so makes mucosal appearance less pink and more white
cause of lichen planus
lupus erythematous
GVHD
how does lichen planus cause white lesion
associated with acanthosis which is thickening of epithelial layers reducing visibility to epithelial blood flow reducing pinkness and increased whiteness of mucosa
how does candida leukoplakia cause white lesions
candida cause a lot of inflammation within epithelium and surrounding tissue and this inflammation causes fluid to accumulate in epithelium reducing blood flow visibility
how does carcinoma appear white
thickening of cells as these are proliferating in an uncontrolled manner making blood flow appearance through tissues less
why are white lesions white
thickening of mucosa or keratin layer
less blood in tissues
what is leukplakia
a white patch which cannot be scraped off or attributed to any other cause
white lesions that is not otherwise explained
does leukoplakia have a histopathological connotation
no, it is a clinical description
what are Fordyces spots
ectopic sebaceous glands
usually in the buccal mucosa or on the lips
benign and normal structures
what causes frictional keratosis
traumatic source usually
e.g. clenching habit and the clenching pulls buccal mucosa in with the buccinator muscle contraction so cusp edges rub against the mucosa which causes reactive thickening of mucosa = keratotic thickening
what is smoker’s keratosis
trauma from thermal gases
reactive change again
what colour is smokers keratotis
white
keratosis is thickening of the mucosa so harder to see blood flow through CT
how much more likely are smokers to get leukoplakia
6x more
how does trauma to the mucosa cause melanin pigment to be seen histologically
melanocytes overproduce melanin from the trauma
what is the malignant potential of smokers keratosis lesion
low risk of the lesion
but higher risk of oral cancer overall because pt is a smoker
what is hereditary keratosis
not a traumatic keratosis
start posterior in mouth and spread anteriorly in buccal mucosa up and down into sulcus
genetic factors
what does hereditary keratosis look like
white sponge appearance caused by fluid accumulating between the epithelial cells in superficial layer and fluid is making it difficult to see through so can’t see blood vessels, so area more white appearing
if pt has a malignancy associated with a lesion what would it look like
would have inflammatory process surrounding it
if there is normal mucosa around a lesion that is less worrying
why does idiopathic keratosis happen
not for any reason
genetic programming in the cell switches to produce more keratin than usual in this area
why is taking biopsy of gingival margin hard
could be a pocket which then means if you biopsy there it would make the gingiva non-viable and then could turn necrotic and die off and you would lose the gingival margin
how does chemical burn happen
acidic substance (tablet) held in contact with mucosa causing coagulation of the proteins and damage to the epithelial surface
how does hairy leukoplakia happen on tongue
elongation of papilla on side of tongue and thickening of surface due to incorporation of EBV into the genetic code of cells causing them to reproduce at a faster rate
what is another name for pseudomembranous candidiasis
thrush
what is oral thrush
white lesions all over the soft palate and uvula
can be scraped off
once scraped off will leave an inflammatory change and red bleeding area underneath the lesion
what is a pseudomembrane
not firmly adhered to the mucosa and not part of the mucosa so can be scraped off
