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Module 7 > ORAL PATH ulcerated lesions > Flashcards

ORAL PATH ulcerated lesions Flashcards

1
Q

what is an ulcer?

A

localised surface defect with loss of epithelium exposing underlying inflamed connective tissue

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2
Q

what are the causes of ulcers?

A

infection
trauma
drugs
idiopathic
systemic disease
dermatological disease
neoplasm

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3
Q

what viral infections are associated with oral ulceration?

A

HSV
VZV
CMZ
Coxsackie

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4
Q

what are types of trauma that may cause oral ulceration?

A

mechanical
chemical
thermal
factitious injury
radiation

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5
Q

give examples of drugs that cause oral ulceration

A

nicorandil
NSAIDs

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6
Q

what type of oral ulceration is idiopathic?

A

recurrent aphthous stomatitis

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7
Q

what systemic diseases are associated with oral ulceration?

A

haematological disease
GI disease
HIV

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8
Q

what dermatological diseases are associated with oral ulceration?

A

lichen planus
discoid lupus erythematosus
immunobullous disease

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9
Q

what oral ulcerations are neoplastic?

A

oral SCC
salivary gland neoplasms or metastases

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10
Q

what do a large proportion of ulcers show histopathologically?

A

non-specific features such as loss of surface epithelium, inflamed fibrinoid exudate and inflamed granulation tissue

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11
Q

what is a vesicle?

A

small blister < 10mm

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12
Q

what is a bulla?

A

blister >10mm

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13
Q

why do vesiculobullous lesions occur?

A

rupture of vesicles/ bullae

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14
Q

what are immunobullous disorders?

A

autoimmune diseases in which autoantibodies against components of skin and mucosa produce blisters

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15
Q

how would you histologically classify disorders which result in vesicles/ bullae?

A

classify depending on the location of the bulla:
1. intraepithelial
2. subepithelial

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16
Q

what are the 2 classifications of intraepithelial vesiculobullous lesions?

A

non-acantholytic (death and rupture of cells)
acantholytic (desmosomal breakdown)

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17
Q

give examples of intraepithelial non acantholytic vesiculobullous lesions?

A

HSV in primary herpetic stomatitis and herpes labialis

18
Q

give examples of intraepithelial acantholytic vesiculobullous lesions

A

pemphigus: vulgaris, drug-induced and paraneoplastic types

19
Q

what is the most common and most severe type of pemphigus?

A

vulgaris

20
Q

what type of patients does pemphigus vulgaris frequently show in?

A

females 40-60 years

21
Q

cause of pemphigus vulgaris?

A

autoantibodies to desmosomal protein (desmoglein 1 or 3) produced

22
Q

treatment for pemphigus vulgaris?

A

steroids

23
Q

how is pemphigus vulgaris and mucous membrane pemphigoid diagnosed?

A

direct immunofluorescence (DIF) studies used in conjunction with routine histopathology to confirm diagnosis - fresh specimen is mandatory for DIF

24
Q

Explain how direct immunofluorescence diagnoses pemphigus vulgaris?

A

antibody to IgG attaches to pts autoantibody which is present around prickle cells as it is attacking the desmosomal proteins

25
Q

what are examples of subepithelial vesiculobullous lesions?

A

pemphigoid
erythema multiforme
dermatitis herpetiformis
epidermolysis bullosa acquisita

26
Q

what is pemphigoid?

A

a group of autoimmune diseases?

27
Q

types of pemphigoid?

A

bullous pemphigoid
mucous membrane pemphigoid
linear IgA disease
drug-induced pemphigoid

28
Q

what patients does mucous membrane pemphigoid usually present in?

A

females aged 50-80

29
Q

what sites are affected by mucous membrane pemphigoid?

A

gingiva, buccal mucosa, tongue, palate

30
Q

what do mucous membrane pemphigoid lesions present as?

A

desquamative gingivitis

31
Q

apart from oral mucosa, what sites are also affected by mucous membrane pemphigoid?

A

eyes, nose, larynx, pharynx, oesophagus, genitalia

32
Q

describe the bullae of mucous membrane pemphigoid?

A

tend to be relatively tough - full thickness epithelium

when they rupture they heal slowly with scarring

ocular lesions can lead to blindness

33
Q

what is the treatment for mucous membrane pemphigoid?

A

steroids

34
Q

what is epidermolysis bullosa acquisita?

A

an uncommon acquired autoimmune blistering dermatosis with subepithelial bullae

35
Q

how does epidermolysis bullosa acquisita present?

A

oral lesions in 50% cases
early stage may mimic pemphigoid and later resembles epidermolysis bullosa

presents as desquamative gingivitis

36
Q

what is epidermolysis bullosa?

A

group of rare genetic conditions in which skin bullae form and heal with scarring

37
Q

what are the 3 variants of epidermolysis bullosa?

A

simplex
junctional
dystrophic

38
Q

how does epidermolysis bullosa present?

A

blistering and erosion of lips

39
Q

what is angina bullosa haemorrhagica?

A

oral blood blisters

40
Q

where are oral blood blisters commonly found?

A

soft palate

Module 7 (33 decks)

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