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D2 Spring > Oral Path Exam 2 - Blue, Brown, Gray, and Black Lesions > Flashcards

Oral Path Exam 2 - Blue, Brown, Gray, and Black Lesions Flashcards

1
Q

What lesions?

Caused by increase in production of melanin by melanocytes, but there is a normal number of melanocytes

A

Physiologic (racial) pigmentation
Smoker’s melanosis

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2
Q

What lesion?

Found in pts with darker complexion

A

Physiologic (racial) pigmentation

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3
Q

What lesion?

Most common location = attached gingiva

A

Physiologic (racial) pigmentation

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4
Q

What lesion?

Can be seen anywhere, even tips of fungiform papillae on dorsal tongue

A

Physiologic (racial) pigmentation

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5
Q

What lesion?

Diagnosis is established clinically; biopsy is not conclusive w/o clinical correlation

A

Physiologic (racial) pigmentation

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6
Q

What lesions?

No tx necessary

A

Physiologic (racial) pigmentation
Amalgam tattoo
Drug-related pigmentation
Melanotic macule

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7
Q

What lesion?

Caused by autosomal dominant genetic disease

A

Peutz-Jeghers syndrome

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8
Q

What lesion?

Oral and perioral freckles that first present during childhood and adolescence; lips and cheeks

A

Peutz-Jeghers syndrome

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9
Q

What lesion?

Skin and mucosal freckles

A

Peutz-Jeghers syndrome

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10
Q

What lesion?

Multiple GI hamartomatous polyps; do not have same level risk of transformation to colorectal cancer as adenomatous polyps

A

Peutz-Jeghers syndrome

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11
Q

What lesion?

Increased risk of malignancy (GI, pancreatic, breast, ovarian)

A

Peutz-Jeghers syndrome

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12
Q

What lesion?

Diagnosed by family history and genetic testing

A

Peutz-Jeghers syndrome

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13
Q

What lesion?

Oral/perioral biopsy is not supportive for diagnosis

A

Peutz-Jeghers syndrome

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14
Q

What lesion?

Oral and perioral pigmentation persists throughout life and does not require tx

A

Peutz-Jeghers syndrome

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15
Q

What lesion?

Tx = lifelong monitoring for development of neoplasia

A

Peutz-Jeghers syndrome

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16
Q

What lesion?

Caused by amalgam becoming embedded in oral mucosa

A

Amalgam tattoo

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17
Q

What lesion?

Pts w/ history of amalgam restorations

A

Amalgam tattoo

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18
Q

What lesion?

Presents as black, blue, or gray macules

A

Amalgam tattoo

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19
Q

What lesion?

Most common locations = gingiva, alveolar mucosa, and buccal mucosa

A

Amalgam tattoo

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20
Q

What lesion?

May appear as a dense radiopacity on X-Ray

A

Amalgam tattoo

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21
Q

What lesion?

Diagnosed by X-Ray and biopsy

A

Amalgam tattoo

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22
Q

What lesion?

MUST be distinguished from melanocytic neoplasia

A

Amalgam tattoo

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23
Q

When should you biopsy an amalgam tattoo?

A

When you take an X-Ray but don’t see a radiopacity

(if you see radiopacity then you know it’s amalgam, if not, you need to make sure it is not melanocytic neoplasia)

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24
Q

What lesion?

Caused by protective response against noxious chemicals in tobacco smoke

A

Smoker’s melanosis

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25
Q

What lesion?

Females are affected at a higher frequency

A

Smoker’s melanosis

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26
Q

What lesion?

Most common location = anterior facial mandibular gingiva

A

Smoker’s melanosis

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27
Q

What lesion?

Looks like multiple brown macules

A

Smoker’s melanosis

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28
Q

What lesion?

Correlate clinical presentation w/ smoking history and med history

A

Smoker’s melanosis

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29
Q

What lesion?

If you have any doubt, biopsy to rule out neoplasia

A

Smoker’s melanosis

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30
Q

What lesion?

Pigmentation can disappear after smoking cessation

A

Smoker’s melanosis

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31
Q

What lesion?

Cause is different for different medications; some chelate w/ iron or melanin and deposit in lamina propria, some stimulate melanocytes to produce melanin

A

Drug-related pigmentation

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32
Q

What lesion?

Pt taking medication known to cause pigmentation

A

Drug-related pigmentation

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33
Q

What 6 drugs are known to cause pigmentation?

A

Miocycline
Antimalarials
Tranquilizers
Chemotherapeutic agents
Estrogen
AIDS meds

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34
Q

What category are the following meds?

Chloroquine
Hydroxychloroquine
Quinidine
Quinacrine

A

Antimalarials

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35
Q

What category is the following med?

Chlorpromazine

A

Tranquilizers

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36
Q

What category is the following med?

Imatinib

A

Chemotherapeutic agents

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37
Q

What category is the following med?

Zidovudine/AZT

38
Q

What lesion?

Diffuse, painless, symmetric, bluish-gray macular pigmentation of hard palate

A

Drug-related pigmentation

39
Q

What lesion?

Correlation btwn initiation of drug and onset of pigmentation

A

Drug-related pigmentation

40
Q

What lesion?

Biopsy may be suggestive of drug-related pigmentation, or may require clinical correlation

A

Drug-related pigmentation

41
Q

What lesion?

Increase in melanin and sometimes number of melanocytes

A

Melanotic macule

42
Q

What lesion?

2:1 female predilection

A

Melanotic macule

43
Q

What lesion?

Average age is 42

A

Melanotic macule

44
Q

What lesion?

Solitary, uniformly tan to dark-brown

A

Melanotic macule

45
Q

What lesion?

Most common location = lower lip

A

Melanotic macule

46
Q

What lesion?

Diagnosed by biopsy especially if recent onset, large size, irregular pigmentation, unknown duration, or recent enlargement

A

Melanotic macule

47
Q

What lesion?

Caused by benign localized proliferation of nevus (melanocytic) cells derived from neural crest

A

Melanocytic nevus (“mole”)

48
Q

What lesion?

10-40 cutaneous nevi per white adult (common)

A

Melanocytic nevus (“mole”)

49
Q

What lesion?

Uncommon intraorally, but can occur on any oral soft tissue site

A

Melanocytic nevus (“mole”)

50
Q

What type of nevus?

Brown/black macule

A

Junctional nevus

51
Q

What type of nevus?

Brown/tan papule

A

Compound nevus

52
Q

What type of nevus?

Brown/tan papule w/ papillomatous surface; hair may grow from center

A

Intradermal/intramucosal nevus

53
Q

What lesion?

Clinical diagnosis can be made on skin, biopsy if there is any doubt

A

Melanocytic nevus (“mole”)

54
Q

What lesion?

Biopsy is necessary if it is intraoral

A

Melanocytic nevus (“mole”)

55
Q

What lesion?

Biopsy is necessary if > 6 mm

A

Melanocytic nevus (“mole”)

56
Q

What lesion?

Tx = monitor signs for change; small % develop into melanoma

A

Melanocytic nevus (“mole”)

57
Q

What lesion?

Caused by benign proliferation of dendritic melanocytes usually deep within CT

A

Blue nevus

58
Q

What lesion?

Female predilection
Usually in children + young adults

A

Blue nevus

59
Q

What lesion?

Macular or dome-shaped, blue or blue-black

A

Blue nevus

60
Q

What lesion?

Smaller than 1 cm

A

Blue nevus

61
Q

What lesion?

Found on any cutaneous or mucosal site

A

Blue nevus

62
Q

What lesion?

Most common oral location = palate

A

Blue nevus

63
Q

What lesion?

Biopsy is a definitive diagnosis

A

Blue nevus

64
Q

What lesion?

Tx = surgical excision

A

Blue nevus

65
Q

What lesion?

Caused by malignancy of melanocytic cells

66
Q

What are the 4 risk factors for cutaneous melanoma?

A

Acute sun damage
Fair complexion
Multiple moles, freckling, dysplastic nevi
Family hx

67
Q

What lesion?

Male predilection
Found in 5th-7th decade of life

A

Oral melanoma

68
Q

What % of melanomas are found in the following?

Head and neck
Extremities
Intraoral

A

Head and neck: 25%
Extremities: 40%
Intraoral: < 1%

69
Q

What are the ABCDEs of melanoma?

A

Asymmetry
Borders (irregular)
Color variegation
Diameter (> 6 mm)
Evolving

70
Q

What lesion?

Diagnosed by biopsy

71
Q

What lesion?

Tx = wide surgical excision, radiation, immunotherapy

72
Q

What lesion?

Depth of invasion is an important prognostic factor

73
Q

Which melanoma has a worse prognosis: oral melanoma or cutaneous melanoma?

A

Oral melanoma

(< 20% 5-year survival)

74
Q

What lesion?

Caused by decreased production of cortisol and mineralocorticoids; increased ACTH production by anterior pituitary

A

Addison disease

75
Q

What lesion?

Caused by adrenocortical insufficiency secondary to autoimmune adrenalitis, TB, sarcoidosis, adrenal hemorrhage, and metastatic cancer

A

Addison disease

76
Q

What lesion?

Effects broad range of people, dependent on cause

A

Addison disease

77
Q

What lesion?

Generalized hyperpigmentation of the skin (bronzing)

A

Addison disease

78
Q

What lesion?

Diffuse or patchy, brown, macular pigmentations of oral mucosa

A

Addison disease

79
Q

What lesion?

Weakness, weight loss, irritability, depression, nausea, vomiting, hypotension

A

Addison disease

80
Q

What lesion?

Diagnosed by decreased serum cortisol levels and increased plasma ACTH levels

A

Addison disease

81
Q

What lesion?

Tx = steroid replacement therapy and tx of underlying condition

A

Addison disease

82
Q

T/F: You should always biopsy pigmented lesions

83
Q

What category of disease?

Physiologic (racial) pigmentation

A

Developmental

84
Q

What category of disease?

Peutz-Jeghers syndrome

A

Developmental

85
Q

What category of disease?

Amalgam tattoo

86
Q

What category of disease?

Smoker’s melanosis

87
Q

What category of disease?

Drug-related pigmentation

88
Q

What category of disease?

Melanotic macule

A

Neoplastic

89
Q

What category of disease?

Melanocytic nevus

A

Neoplastic

90
Q

What category of disease?

Blue nevus

A

Neoplastic

91
Q

What category of disease?

Melanoma

A

Neoplastic

92
Q

What category of disease?

Addison disease

D2 Spring (46 decks)

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