Oral Path 3 (march on! march onward!) Flashcards
Which cutaneous ulcerative disease have a positive nikolsky’s sign? What does that mean?
- pemphigus vulgaris
- Mucous membrane/bullous pemphigoid
- EB
- Put pressure on surface of skin/mucosa an a bulla will form
Systemic connective tissue disease which may manifest with oral ulcerations?
- Lupus erythematous
- Reiter’s syndrome (an inflammatory arthritis of large joints)
- Mixed connective tissue disease
- Felty’s syndrome (infective arthritis w/swollen spleen and decreased WBC)
Herpetic gingivostomatitis: virus? presentation pain? tx?
HSV type 1 -oral ulcers, gingivitis, fever - Peak age 2-3 years - Transmission : direct contact, saliva -Site oropharyngeal anogenital cutaneous - Duration 5-14 days: inoculation 1 week Tx: palliative, systemic antiviral
Hand food mouth disease : virus? ages? symptoms
Cocksackie virus
- infants to 4 yo
- fever, malaise, lympadenopathy
- Vesciles and ulcerations intraorally and on hands, feet, legs
- Duration 7-10day
- tx: supprotive/palliative
Herpangina: virus? what happens? tx?
Cocksackie virus
- present with multiple vescular lesions involving the POSTERIOR mouth: uvula, tonsillar pillars, soft palate
- Vesicles rupture leaving ulcerations
- most common in summer
tx: supprotive
Acute Necrotizing Ulcerative Gingivitis
Fusiform bacteria, spirochetes
- rare in young children, but seen in adolescents and in developing countries
- site attached gingiva, interdental papilla, edema, ulceration
- necrosis, ulceration, punched out papilla
- tx: OHI, topical/systemic antibiotics (#1 is metronidazole; penicillin, amox)
Drugs assoc w/severe ulcerating of gingiva
Methotrexate, cytotoxics, 5-FU, NSAIDs
Triad of histiocytosis (langerhan’s cell histiocytosis):
- A disorder of what?
- What are the major types and the key characteristics of each?
- What do they present with clinically?
Mononuclear phagocyte disorder
Major types:
- Acute dessiminated form (worst prognosis) ,
- hand-scheuller christian chronic form classic triad of diabetes inspidus, exopthalamos and skull lesions.
- Acute localized form (eosinophilic granuloma) - lesions are limited to bone.
- Present w/soft tissue involvement, necrotic tissue, loss of attachment generally involving the POSTERIOR of the mouth
Carotenimia vs jaundice
Sclera is uninvolved in carotenemia
Addison’s Disease: what kind of problem? cause? clinically what occurs EOE/IOE? Other problems??
- Endocrinopathy
- Cause: destruction of adrenal cortex or decreased production of ACTH
- Bronzing of the skin, diffuse brown macules in the oral mucosa
- Hypotension, depression, weakness
Melasma: assoc with? what occurs?
Associated w/pregnancy, oral contraceptives, hormone replacement therapy
- Symmetrical pigmentation of face and neck (what vanessa had)
Acanthosis Nigrans: associated with? What occurs? where?
Assoc w/GI cancer, diabetes, hypothyroidism, addison’s disease, acromegaly, steroid, oral contraceptive use
- Velvety brown papules and plaques on the neck, axilla, flexural skin
- Fine papules on lips, tongue, and palate
Peutz- Jegher’s Syndrome: genetics (inheritance and involved gene)? what is it? what else is assoc’d w/it? Age? Site? Prognosis and Tx?
AD, STK11 gene mutation
- Periorofacial freckling around the lips, nose, oral mucosa, and hands. Anemia, rectal bleeding, small GI polyps
- First decade of life
Tx: none req’d for oral lesions, high risk for developing multiple cancers including colon cancer. Intestinal polyps may req sx
Melanoma: % of pediatric cancers? age? gender? lifetime risk? location? what is assoc w/poorer prognosis
1-3% of pediatric cancers
Age: in utero to age 21, 75% are teenagers
- Gender F>
- Lifetime risk 1/75
Location skin/mucous membranes
- Poorer prognosis: head, neck, face, eye, and oral
Melanotic Macule: cause? site? tx?
Cause: a focal increase in melanin
Site: lip, buccal mucosa, gingiva, palate
Tx: none
