Oral Pathology Flashcards
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painful ulcers of nonkeratinized mucosa
red halo boarder
heals in 1-2 weeks
minor ⇒ <1cm, 7-10 days to heal
major ⇒>1cm, several weeks to heal; common with immunodeficient conditions
Aphthous Ulcers
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- benign
- red/purple lesions that easily bleed
- max ant facial most common
- tx: surgical excision with biopsy
Pyogenic Granuloma
AKA Pregnancy Tumor
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target, iris, or bulls eye type lesion
onset is explosive
minor ⇒secondary heres simplex hypersensitivity
severe*⇒steven-johnson syndrome
Erythema Multiforme
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benign
Wickhams Striae - white lines
most common on buccal mucosa
Lichen Planus
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Extremely common malignancy
can metastasize to lymph nodes
alcohol and tobacco are predisposing factors
tx: surgical excision and/or radiation therapy
Squamous Cell Carcinoma
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Malignant
Most common skin cancer
chronic ulcers with rolled boarders
caused by chronic sunday exposure
Basal Cell Carcinoma
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Malignant
3rd most common skin cancer, but most fatal
lesions blue-black and >6mm
Melanoma
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Premalignant
grey-white
idiopathic
doesnt wipe off
tx: biopsy and exercise
Leukoplakia
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Benign
Cauliflower or wart-like appearance*
white due to keratin
similar appearance to verruca vulgaris
Papilloma
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dark staining of keratin on filiform papillae due to tobacco and/or alcohol
asymptomatic
benign
tx: eliminate predisposing factors, maintain oral hygiene
Hairy tongue
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atrophy of filiform papillae
AKA benign migratory glossitis
can cause a burning sensation
no tx indicated
Geographic Tongue
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flat and erythematous
midline of dorsal tongue
loss of filiform papillae
no tx
Median Rhomboid Glossitis
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Salivary Stones mainly affect submandibular gland
tx: milking the duct, moist heat, increase fluid intake
Sialolith
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chronic sialolith/trauma on floor of mouth
larger than mucocele
movable, blueish
tx: allow to heal or surgery if necessary
Ranula
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- on lower lip, caused by trauma
- large, but smaller than ranula
- blue, pink if deeper
- tx: surgery if needed
Mucocele
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- Associated with immunodeficiency
- white lesion, can be wiped off
- red, atrophic, on mucosal area
- asymptomatic
- tx: antifungal
Candidiasis
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- autoimmune disease causing blistering of skin
- fragile and painful
- pacantholysis: blister separating epithelial cells
- nikolskys sign: cleavage by gentle finger pressure
Pemphigus Vulgarism
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tongue tied due to adhesion of tongue to floor of mouth
short, thick lingual frenum
Ankyloglossia
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benign lesion on hard palate due to heat from tobacco smoke
completely reversible
Nicotine Stomatitis
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Associated with denture stomatitis
- red mucosa with pebbly appearance
- asymptomatic
- tx: remove denture nightly, antifungals
Papillary Hyperplasia
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inflammatory hyperplasia
caused by ill fitting prosthetics
tx: surgical removal, remake prosthetic
Epulis Fissuratum
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- lesions on keratinized mucosa fixed to bone
- symptoms ⇒ burning, tingling, pain
- lesions disappear in 1-2 days without scarring
- HSV 1 ⇒ oral, triggered by stress
- HSV 2 ⇒ genital
- Herpetic Whitlow ⇒ infection of fingers
Herpes
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Inflamed gingiva in teeth with large carious lesions
asymptomatic
tx: extraction, root canal
Pulpitis
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Chickenpox (bilateral)
Shingles (unilateral)
Varicella-Zoster
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Coxsacie Virus
red, ulcerated macules
tx: symptomatic relief
Hand-Foot-Mouth Disease
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blue-grey lesion from amalgam left in tissue
radiographic diagnosis
*most common oral pigmented lesion
Amalgam Tattoo
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purple/blue enlarged vessels
ventral and lateral boarders of tongue
in adults/elders
Lingual Varicosity
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Clusters of sebaceous glands on lips and buccal mucosa
yellow-white
in >80% of adults
Fordyce Granules
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AKA Downs Syndrome
- fissured tongue
- macroglossia
- taurodontism
- periodontal disease
- microdontia
- hypodontia
- hypersalivation
- delayed exfoliation
Trisomy 21 Oral Manifestations
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grey-milky opalescent appearance of mucosa
disappears when tissues are stretched
common in African American adults and smokers
idiopathic
Leukodema
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white line of hyperkeratosis on buccal mucosa
- associated with parafunctional habits
- no treatment needed
Linea Alba
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Cancer of lymph/blood vessles
caused by AIDS
blue-purple macule
tumors on palate/gingiva/skin
Kaposi’s Sarcoma
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2-3mm marginal line of redness
- due to lack of response to oral self care and/or periodontal therapy
- tx:
- chlorohexadine gluconate 0.12
- antibiotics
- antiretroviral therapy
- antifungal therapy
Linear Gingival Erythema
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produces hormones in kidney
Cortex: cortisol, aldosterone, androgenic steroids
Medulla: epinephrine and norepinephrine
Adrenal Gland
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idiopathic freckle
may be syndrome associated
Melanotic Macule
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AKA thyroid storm
Causes: graves disease, thyroid issues
tx: radioactive iodine, methimazole, propylthiouracil, surgery
Hyperthyroidism
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- Adults: thickened lips, enlarged tongue
- Children: failure of eruption of permanent dentition
- Causes: autoimmune disease, radioactive treatment
- tx: levothyroxine
Hypothyroidism
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Anatomical location
Boarder
Colour
Dimension
Type
Nomenclature to Describe Lesions
(ABCD+T)
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caused by Paramyxovirus
- parotid gland enlargement
- pain when chewing
- palliative tx
Mumps
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most common benign salivary tumor
- epithelial and connective tissue
- parotid gland, palate
- painless
- tx: surgical excision, excellent prognosis
Mixed Tumor
(Pleomorphic Adenoma)
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Tumor containing lymphoid tissue
- 2nd most common parotid gland tumor
- bilateral
- older men
- tx: surgical excision
Warthins Tumor
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Butterfly Rash
women more effected
lesions are ulcerated, erythematous, white center
Lupus
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abnormal gingival growth
caused by phenytoin, nifedipine, cyclosporin
tx: gingivectomy, discontinue medication, review oral health instruction
Gingival Hyperplasia
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Common tumor-like growth
- reactive lesion caused by local irritation/trauma
- mandibular
- mostly in females 21-41y/o
- tx: surgery, scaling to remove irritation
Peripheral Giant Cell Granuloma
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Strong association with geographic tongue
grooves in tongue
benign, asymptomatic, idiopathic
no tx indicated
Fissured Tongue
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Type 1
- Insulin dependant
- Juvenile onset
- hyperglycemia and ketoacidosis
- exogenous insulin injections
Type 2
- Non-insulin dependant
- adult onset
- hyperglycemia
- tx: oral medications, insulin
Diabetes
Type 1 vs Type 2
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Generally Type 1
- periodontal disease
- xerostomia
- enlargement/erythema of gingiva
- glossitis
- candidiasis
Diabetes Oral Manifestations
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Cushing Syndrome (“Fat so fall is cushioned”)
- causes⇒ tumor, corticosteroid therapy
- reversible clinical feautures (buffalo hump, moon face)
- tx: surgical removal, radiation therapy, corticosteroid-sparing agents
Hypercorticism
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Addisons Disease (“addison is skinny”)
- low cortisol levels
- weight loss, weakness, hypotension
- patchy, brown, macular pigmentation in oral cavity
- tx: prednisone (corticosteroid)
Hypoadrenocorticism
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secretes hormones regulating growth and development
- T3 and T4 hormones regulate breathing, heart rate, CNS, PNS, muscle strength, menstrual cycles, body temperature, metabolism,, brain development
Thyroid Gland
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- Nevus: mole or birthmark
- benign tumor of melanocytes
- on hard palate, buccal mucosa
- genetic predisposition
Melanocytic Nevus
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benign tumor of mature fat cells
- yellow mass on buccal mucosa and vestibule
Lipoma
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hyperkeratosis of epithelium caused by friction against tissue
- white
- nonmalignant
- resembles leukoplakia (monitor)
Frictional Keratosis
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most common tumor in oral cavity
reactive hyperplasia of connective tissue
along bite lines, smooth surfaces
asymptomatic
Fibroma
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Malignant tumor of bone-forming tissue
Sunburst pattern
teens and elders effected
Osteosarcoma
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white necrotic tissue that may slough off
- painful
- caused by aspirin tablet placed on gingiva instead of swallowing
- heals in 7-10 days spontaneously
Aspirin Burn
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hereditary condition
- bone in mandible replaced by excessive fibrous tissue
- under age 20
- bilateral expansion of max and mand
- premature loss of primary teeth, non-eruption of permanent teeth
Cherubism
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pre-cancerous, related to sunday exposure
fair-skinned individuals
lower lip and vermillion boarder most affected
Solar (actinic) Cheilitis
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diffuse, painless, thick plaque
- slow growing
- leukoplakia, tobacco pouch keratosis
- tobacco and HPV are predisposing factors
- metastasis is extremely rare
Verrucous Carcinoma