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D2 Spring > Oral Path Exam 2 - Benign White Lesions > Flashcards

Oral Path Exam 2 - Benign White Lesions Flashcards

1
Q

Why does an oral lesion look white? (5)

A

Edema in tissue
Necrosis (variable thickness, +/- removable)
Superficial coatings (removable)
Keratin (more or change in type)
Thickening of epithelium

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2
Q

Which cause of a white lesion?

Disappears w/ stretching

A

Edema

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3
Q

Example of edema

A

Leukoedema (buccal mucosa)

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4
Q

Which cause of a white lesion?

+/- removable

A

Extrinsic coatings (organisms)

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5
Q

Examples of extrinsic coatings

A

Coated tongue
Hairy tongue
Plaque
Candida (burning/irritated sensation, can also be red)

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6
Q

Which cause of a white lesion?

Leads to cauterized or superficial sloughed epithelium; +/- removable

A

Thermal or chemical injury

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7
Q

Examples of thermal or chemical injury

A

Toothpaste
Mouthwash

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8
Q

Which cause of a white lesion?

Non-removable

A

Keratin increased and/or epithelial lining

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9
Q

Examples of keratin increased and/or epithelial lining

A

Frictional keratosis (linea alba, tongue/cheek chewing, alveolar ridge)
Nicotine stomatitis
Hairy leukoplakia (immunosuppression)
Smokeless tobacco keratosis
Leukoplakia

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10
Q

Where is orthokeratinized tissue in the mouth normally?

A

Palate
Gingiva

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11
Q

Why do we care about white lesions?

A

Some require no tx
Some are easily treated
Some have precancerous potential or indicate systemic disease

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12
Q

What type of white lesion?

“White line”

A

Linea alba

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13
Q

What type of white lesion?

Non-removable, white line along occlusal plane

A

Linea alba

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14
Q

What type of white lesion?

Caused by chronic, low-grade, frictional trauma

A

Linea alba

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15
Q

What type of white lesion?

No tx needed, just recognize that it is there

A

Linea alba
Leukoedema

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16
Q

What type of white lesion?

Asymptomatic

A

Linea alba
Leukoedema
Dentrifice-associated slough

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17
Q

What type of white lesion?

Non-removable, opalescent/pale white appearance of buccal mucosa that diminishes when stretched

A

Leukoedema

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18
Q

What type of white lesion?

More common in black adults and smokers

A

Leukoedema

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19
Q

What are the 4 key questions for leukoedema?

A

Is it removable?
Does it disappear when stretched?
Is it on the other side?
Is it asymptomatic?

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20
Q

What type of white lesion?

Very common on dorsal tongue, white in color

A

Coated tongue

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21
Q

What type of white lesion?

Can be misdiagnosed as candidiasis

A

Coated tongue

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22
Q

What type of white lesion?

May have malodor

A

Coated tongue

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23
Q

What type of white lesion?

Tx: scrape tongue

A

Coated tongue

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24
Q

What type of white lesion?

Elongated, discolored, filiform papillae

A

Hairy tongue

25
Q

What type of white lesion?

Associated with smoking

A

Hairy tongue

26
Q

What type of white lesion?

Discoloration (brown, black, green, yellow) due to bacteria, food, and tobacco

A

Hairy tongue

27
Q

What type of white lesion?

Asymptomatic, or gagging if long; bad taste

A

Hairy tongue

28
Q

What type of white lesion?

Tx: brush tongue and stop smoking to reduce lesions

A

Hairy tongue

29
Q

What type of white lesion?

Common, often related to tartar control, whitening, sensitivity control, multi-care toothpaste, or overuse of mouthwash

A

Dentrifice-associated slough

30
Q

What type of white lesion?

Mild peeling, sloughing or superficial keratin layers, labial/buccal mucosa and floor of mouth

A

Dentrifice-associated slough

31
Q

What type of white lesion?

Tx: bland toothpaste

A

Dentrifice-associated slough

32
Q

What type of white lesion?

Non-removable, white, ragged, but possibly partially peeling surface texture

A

Morsicatio (cheek/tongue chewing)

33
Q

What type of white lesion?

Found on labial and anterior buccal mucosa and lateral tongue

A

Morsicatio (cheek/tongue chewing)

34
Q

What type of white lesion?

Caused by chronic, low-grade, frictional trauma

A

Morsicatio (cheek/tongue chewing)

35
Q

What type of white lesion?

Typically no tx needed, just recognize that it is there -> unless extensive, which might require biopsy to exclude premalignant changes

A

Morsicatio (cheek/tongue chewing)

36
Q

What type of white lesion?

Tx could include pt education and occlusal guard

A

Morsicatio (cheek/tongue chewing)

37
Q

What type of white lesion?

Asymmetric, spread off the alveolar ridge

A

Alveolar ridge keratosis

38
Q

What type of white lesion?

Basically a callous response to eating when a tooth is missing. Food compacts on the ridge, and you get a pressure response

A

Alveolar ridge keratosis

39
Q

T/F: Most cases of alveolar ridge keratosis lacked dysplasia

40
Q

What type of white lesion?

The pts who did have dysplasia had 1+ of the following:
Verrucous appearance
Tobacco use
Alcohol use
Multiple white lesions
Previous squamous cell carcinoma

A

Alveolar ridge keratosis

41
Q

What type of white lesion?

Erythema or ulceration warrants biopsy

A

Alveolar ridge keratosis

42
Q

What type of white lesion?

White keratotic change induced by heat of tobacco smoking or hot beverages

A

Nicotine stomatitis

43
Q

What type of white lesion?

Found on the posterior hard palate and soft palate

A

Nicotine stomatitis

44
Q

What type of white lesion?

Elevated papules with red center (orifices of minor salivary gland ducts) and white borders

A

Nicotine stomatitis

45
Q

What type of white lesion?

Not precancerous; resolution in 1-2 weeks after habit cessation

A

Nicotine stomatitis

46
Q

What type of white lesion?

Epstein-Barr Virus (EBV) induced lesion, often with superimposed candidiasis

A

Hairy leukoplakia

47
Q

What type of white lesion?

Usually HIV-infected or other immune compromised; rare in healthy pts

A

Hairy leukoplakia

48
Q

What type of white lesion?

Non-removable white plaques of lateral tongue

A

Hairy leukoplakia

49
Q

What type of white lesion?

Faint vertical strands to thick furrowing w/ shaggy keratotic surface

A

Hairy leukoplakia

50
Q

What type of white lesion?

Tx: usually resolves with control of HIV infection

A

Hairy leukoplakia

51
Q

What type of white lesion?

Thick, irregular parakeratin

A

Hairy leukoplakia

52
Q

What type of white lesion?

Candida infection is common

A

Hairy leukoplakia

53
Q

What type of white lesion?

Hyperplastic (thicker) epithelium w/ balloon cells that show EBV by in situ hybridization

A

Hairy leukoplakia

54
Q

What type of white lesion?

No dysplasia
Minimal inflammation

A

Hairy leukoplakia

55
Q

Which white lesions are removable?

A

Coated tongue
Hairy tongue
Dentrifice-associated slough

56
Q

Which white lesions are non-removable?

A

Linea alba
Leukoedema
Morsicatio (cheek/tongue chewing)
Hairy leukoplakia

57
Q

How long does it take tissues in the mouth to turnover?

58
Q

Which benign white lesion should you always biopsy to confirm it is not precancerous?

A

Hairy leukoplakia

D2 Spring (38 decks)

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