Oral Pathology Flashcards
.
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
.
- benign
- red/purple lesions that easily bleed
- max ant facial most common
- tx: surgical excision with biopsy
Pyogenic Granuloma
AKA Pregnancy Tumor
.
target, iris, or bulls eye type lesion
onset is explosive
minor ⇒secondary heres simplex hypersensitivity
severe*⇒steven-johnson syndrome
Erythema Multiforme
.
benign
Wickhams Striae - white lines
most common on buccal mucosa
Lichen Planus
.
Extremely common malignancy
can metastasize to lymph nodes
alcohol and tobacco are predisposing factors
tx: surgical excision and/or radiation therapy
Squamous Cell Carcinoma
.
Malignant
Most common skin cancer
chronic ulcers with rolled boarders
caused by chronic sunday exposure
Basal Cell Carcinoma
.
Malignant
3rd most common skin cancer, but most fatal
lesions blue-black and >6mm
Melanoma
.
Premalignant
grey-white
idiopathic
doesnt wipe off
tx: biopsy and exercise
Leukoplakia
.
Benign
Cauliflower or wart-like appearance*
white due to keratin
similar appearance to verruca vulgaris
Papilloma
.
dark staining of keratin on filiform papillae due to tobacco and/or alcohol
asymptomatic
benign
tx: eliminate predisposing factors, maintain oral hygiene
Hairy tongue
.
atrophy of filiform papillae
AKA benign migratory glossitis
can cause a burning sensation
no tx indicated
Geographic Tongue
.
flat and erythematous
midline of dorsal tongue
loss of filiform papillae
no tx
Median Rhomboid Glossitis
.
Salivary Stones mainly affect submandibular gland
tx: milking the duct, moist heat, increase fluid intake
Sialolith
.
chronic sialolith/trauma on floor of mouth
larger than mucocele
movable, blueish
tx: allow to heal or surgery if necessary
Ranula
.
- on lower lip, caused by trauma
- large, but smaller than ranula
- blue, pink if deeper
- tx: surgery if needed
Mucocele
.
- Associated with immunodeficiency
- white lesion, can be wiped off
- red, atrophic, on mucosal area
- asymptomatic
- tx: antifungal
Candidiasis
.
- autoimmune disease causing blistering of skin
- fragile and painful
- pacantholysis: blister separating epithelial cells
- nikolskys sign: cleavage by gentle finger pressure
Pemphigus Vulgarism
.
tongue tied due to adhesion of tongue to floor of mouth
short, thick lingual frenum
Ankyloglossia
.
benign lesion on hard palate due to heat from tobacco smoke
completely reversible
Nicotine Stomatitis
.
Associated with denture stomatitis
- red mucosa with pebbly appearance
- asymptomatic
- tx: remove denture nightly, antifungals
Papillary Hyperplasia
.
inflammatory hyperplasia
caused by ill fitting prosthetics
tx: surgical removal, remake prosthetic
Epulis Fissuratum
.
- 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
.
Inflamed gingiva in teeth with large carious lesions
asymptomatic
tx: extraction, root canal
Pulpitis
.
Chickenpox (bilateral)
Shingles (unilateral)
Varicella-Zoster
.
Coxsacie Virus
red, ulcerated macules
tx: symptomatic relief
Hand-Foot-Mouth Disease
.
blue-grey lesion from amalgam left in tissue
radiographic diagnosis
*most common oral pigmented lesion
Amalgam Tattoo
.
purple/blue enlarged vessels
ventral and lateral boarders of tongue
in adults/elders
Lingual Varicosity
.
Clusters of sebaceous glands on lips and buccal mucosa
yellow-white
in >80% of adults
Fordyce Granules
.
AKA Downs Syndrome
- fissured tongue
- macroglossia
- taurodontism
- periodontal disease
- microdontia
- hypodontia
- hypersalivation
- delayed exfoliation
Trisomy 21 Oral Manifestations
.
grey-milky opalescent appearance of mucosa
disappears when tissues are stretched
common in African American adults and smokers
idiopathic
Leukodema
.
white line of hyperkeratosis on buccal mucosa
- associated with parafunctional habits
- no treatment needed
Linea Alba
.
Cancer of lymph/blood vessles
caused by AIDS
blue-purple macule
tumors on palate/gingiva/skin
Kaposi’s Sarcoma
.
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
.
produces hormones in kidney
Cortex: cortisol, aldosterone, androgenic steroids
Medulla: epinephrine and norepinephrine
Adrenal Gland
.
idiopathic freckle
may be syndrome associated
Melanotic Macule
.
AKA thyroid storm
Causes: graves disease, thyroid issues
tx: radioactive iodine, methimazole, propylthiouracil, surgery
Hyperthyroidism
.
- Adults: thickened lips, enlarged tongue
- Children: failure of eruption of permanent dentition
- Causes: autoimmune disease, radioactive treatment
- tx: levothyroxine
Hypothyroidism
.
Anatomical location
Boarder
Colour
Dimension
Type
Nomenclature to Describe Lesions
(ABCD+T)
.
caused by Paramyxovirus
- parotid gland enlargement
- pain when chewing
- palliative tx
Mumps
.
most common benign salivary tumor
- epithelial and connective tissue
- parotid gland, palate
- painless
- tx: surgical excision, excellent prognosis
Mixed Tumor
(Pleomorphic Adenoma)
.
Tumor containing lymphoid tissue
- 2nd most common parotid gland tumor
- bilateral
- older men
- tx: surgical excision
Warthins Tumor
.
Butterfly Rash
women more effected
lesions are ulcerated, erythematous, white center
Lupus
.
abnormal gingival growth
caused by phenytoin, nifedipine, cyclosporin
tx: gingivectomy, discontinue medication, review oral health instruction
Gingival Hyperplasia
.
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
.
Strong association with geographic tongue
grooves in tongue
benign, asymptomatic, idiopathic
no tx indicated
Fissured Tongue
.
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
.
Generally Type 1
- periodontal disease
- xerostomia
- enlargement/erythema of gingiva
- glossitis
- candidiasis
Diabetes Oral Manifestations
.
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
.
Addisons Disease (“addison is skinny”)
- low cortisol levels
- weight loss, weakness, hypotension
- patchy, brown, macular pigmentation in oral cavity
- tx: prednisone (corticosteroid)
Hypoadrenocorticism
.
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
.
- Nevus: mole or birthmark
- benign tumor of melanocytes
- on hard palate, buccal mucosa
- genetic predisposition
Melanocytic Nevus
.
benign tumor of mature fat cells
- yellow mass on buccal mucosa and vestibule
Lipoma
.
hyperkeratosis of epithelium caused by friction against tissue
- white
- nonmalignant
- resembles leukoplakia (monitor)
Frictional Keratosis
.
most common tumor in oral cavity
reactive hyperplasia of connective tissue
along bite lines, smooth surfaces
asymptomatic
Fibroma
.
Malignant tumor of bone-forming tissue
Sunburst pattern
teens and elders effected
Osteosarcoma
.
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
.
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
.
pre-cancerous, related to sunday exposure
fair-skinned individuals
lower lip and vermillion boarder most affected
Solar (actinic) Cheilitis
.
diffuse, painless, thick plaque
- slow growing
- leukoplakia, tobacco pouch keratosis
- tobacco and HPV are predisposing factors
- metastasis is extremely rare
Verrucous Carcinoma
.
Smokeless tobacco keratosis
- stretched mucosa appears fissured
- thin grey-white translucent plaque
- severity correlates with quantity of daily use
Snuff Dippers Lesion
.
Most common salivary gland malignancy*
- most common in parotid gland*
- 20-70y/o
- prognosis depends on size of lesion
- low - rarely metastasizes
- high - frequently metastasizes
Mucoepidermoid Carcinoma
.
Dark Pigmentation caused by stimulation of melanin production
Caused by cigarette smoke
- anterior labial gingiva most common
Smokers Melanosis
.
Raised flat area most commonly on muccobuccal fold
can disappear in absence of tobacco
may metastasize
Tobacco Pouch Keratosis
.
Hairy Leukoplakia
- white patches that resemble folds, doesn’t wipe off
- usually not malignant
- cancer “Kaposi’s Sarcoma”
Epstein-Barr Virus
.
Chronic Atrophic Candidiasis
- due to irritation from oral appliances
- tx: remove and clean prosthetics at night, re-size if needed
Denture Stomatitis
.
highly contagious skin infection
- Staphylococcus Aureus or Streptococcus Pyogenes
- vesicles resemble herpes
- young children
- fever does not occur
Impetigo
.
inflammation and infection between tooth and gingiva
erupting 8’s is most common location
Pericoronitis
.
*huchinsons incisors and mulberry molars
- caused by Treponema Pallidum
- sexual transmission
- chancre: primary stage, highly infectious
- mucous patch: secondary stage (apx. 6 weeks after chancre), most infectious stage
- gumma: non-infectious third stage
Syphillis
.
Verruca Vulgaris
- warts transmitted through direct contact
- white, papillary, exophytic lesion
Condyloma acuminatum
- benign, pink lesion, papillary projections
- sexually transmitted
Human Papillomavirus (HPV)
.
overgrowth of compact bone on buccal of max/mand
- no tx
- asymptomatic
Exostosis
.
accumulation of blood in tissue due to trauma
dark in colour
Hematoma
.
tissues entrapped in tongue
mass on midline, posterior to circumvallate papillae
Lingual Thyroid Nodule
.
inherited disorder with frequent decrease in neutrophils (2-3days)
- periodontal disease and ulcerations
- treatment only when neutrophil count is normal
Cyclic Neutropenia
.
Inherited disorder resulting in dwarfism
- polydactyly, hyperplastic nails
- fusion of gingiva from max anteriors
- lack of incisors, have single tooth in center
- natal teeth
Ellis-Van Creveld Syndrome
Reversed
Aphthous Ulcers
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
Reversed
Pyogenic Granuloma
AKA Pregnancy Tumor
- benign
- red/purple lesions that easily bleed
- max ant facial most common
- tx: surgical excision with biopsy
Reversed
Erythema Multiforme
target, iris, or bulls eye type lesion
onset is explosive
minor ⇒secondary heres simplex hypersensitivity
severe*⇒steven-johnson syndrome
Reversed
Lichen Planus
benign
Wickhams Striae - white lines
most common on buccal mucosa
Reversed
Squamous Cell Carcinoma
Extremely common malignancy
can metastasize to lymph nodes
alcohol and tobacco are predisposing factors
tx: surgical excision and/or radiation therapy
Reversed
Basal Cell Carcinoma
Malignant
Most common skin cancer
chronic ulcers with rolled boarders
caused by chronic sunday exposure
Reversed
Melanoma
Malignant
3rd most common skin cancer, but most fatal
lesions blue-black and >6mm
Reversed
Leukoplakia
Premalignant
grey-white
idiopathic
doesnt wipe off
tx: biopsy and exercise
Reversed
Papilloma
Benign
Cauliflower or wart-like appearance*
white due to keratin
similar appearance to verruca vulgaris
Reversed
Hairy tongue
dark staining of keratin on filiform papillae due to tobacco and/or alcohol
asymptomatic
benign
tx: eliminate predisposing factors, maintain oral hygiene
Reversed
Geographic Tongue
atrophy of filiform papillae
AKA benign migratory glossitis
can cause a burning sensation
no tx indicated
Reversed
Median Rhomboid Glossitis
flat and erythematous
midline of dorsal tongue
loss of filiform papillae
no tx
Reversed
Sialolith
Salivary Stones mainly affect submandibular gland
tx: milking the duct, moist heat, increase fluid intake
Reversed
Ranula
chronic sialolith/trauma on floor of mouth
larger than mucocele
movable, blueish
tx: allow to heal or surgery if necessary
Reversed
Mucocele
- on lower lip, caused by trauma
- large, but smaller than ranula
- blue, pink if deeper
- tx: surgery if needed
Reversed
Candidiasis
- Associated with immunodeficiency
- white lesion, can be wiped off
- red, atrophic, on mucosal area
- asymptomatic
- tx: antifungal
Reversed
Pemphigus Vulgarism
- autoimmune disease causing blistering of skin
- fragile and painful
- pacantholysis: blister separating epithelial cells
- nikolskys sign: cleavage by gentle finger pressure
Reversed
Ankyloglossia
tongue tied due to adhesion of tongue to floor of mouth
short, thick lingual frenum
Reversed
Nicotine Stomatitis
benign lesion on hard palate due to heat from tobacco smoke
completely reversible
Reversed
Papillary Hyperplasia
Associated with denture stomatitis
- red mucosa with pebbly appearance
- asymptomatic
- tx: remove denture nightly, antifungals
Reversed
Epulis Fissuratum
inflammatory hyperplasia
caused by ill fitting prosthetics
tx: surgical removal, remake prosthetic
Reversed
Herpes
- 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
Reversed
Pulpitis
Inflamed gingiva in teeth with large carious lesions
asymptomatic
tx: extraction, root canal
Reversed
Varicella-Zoster
Chickenpox (bilateral)
Shingles (unilateral)
Reversed
Hand-Foot-Mouth Disease
Coxsacie Virus
red, ulcerated macules
tx: symptomatic relief
Reversed
Amalgam Tattoo
blue-grey lesion from amalgam left in tissue
radiographic diagnosis
*most common oral pigmented lesion
Reversed
Lingual Varicosity
purple/blue enlarged vessels
ventral and lateral boarders of tongue
in adults/elders
Reversed
Fordyce Granules
Clusters of sebaceous glands on lips and buccal mucosa
yellow-white
in >80% of adults
Reversed
Trisomy 21 Oral Manifestations
AKA Downs Syndrome
- fissured tongue
- macroglossia
- taurodontism
- periodontal disease
- microdontia
- hypodontia
- hypersalivation
- delayed exfoliation
Reversed
Leukodema
grey-milky opalescent appearance of mucosa
disappears when tissues are stretched
common in African American adults and smokers
idiopathic
Reversed
Linea Alba
white line of hyperkeratosis on buccal mucosa
- associated with parafunctional habits
- no treatment needed
Reversed
Kaposi’s Sarcoma
Cancer of lymph/blood vessles
caused by AIDS
blue-purple macule
tumors on palate/gingiva/skin
Reversed
Linear Gingival Erythema
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
Reversed
Adrenal Gland
produces hormones in kidney
Cortex: cortisol, aldosterone, androgenic steroids
Medulla: epinephrine and norepinephrine
Reversed
Melanotic Macule
idiopathic freckle
may be syndrome associated
Reversed
Hyperthyroidism
AKA thyroid storm
Causes: graves disease, thyroid issues
tx: radioactive iodine, methimazole, propylthiouracil, surgery
Reversed
Hypothyroidism
- Adults: thickened lips, enlarged tongue
- Children: failure of eruption of permanent dentition
- Causes: autoimmune disease, radioactive treatment
- tx: levothyroxine
Reversed
Nomenclature to Describe Lesions
(ABCD+T)
Anatomical location
Boarder
Colour
Dimension
Type
Reversed
Mumps
caused by Paramyxovirus
- parotid gland enlargement
- pain when chewing
- palliative tx
Reversed
Mixed Tumor
(Pleomorphic Adenoma)
most common benign salivary tumor
- epithelial and connective tissue
- parotid gland, palate
- painless
- tx: surgical excision, excellent prognosis
Reversed
Warthins Tumor
Tumor containing lymphoid tissue
- 2nd most common parotid gland tumor
- bilateral
- older men
- tx: surgical excision
Reversed
Lupus
Butterfly Rash
women more effected
lesions are ulcerated, erythematous, white center
Reversed
Gingival Hyperplasia
abnormal gingival growth
caused by phenytoin, nifedipine, cyclosporin
tx: gingivectomy, discontinue medication, review oral health instruction
Reversed
Peripheral Giant Cell Granuloma
Common tumor-like growth
- reactive lesion caused by local irritation/trauma
- mandibular
- mostly in females 21-41y/o
- tx: surgery, scaling to remove irritation
Reversed
Fissured Tongue
Strong association with geographic tongue
grooves in tongue
benign, asymptomatic, idiopathic
no tx indicated
Reversed
Diabetes
Type 1 vs Type 2
Type 1
- Insulin dependant
- Juvenile onset
- hyperglycemia and ketoacidosis
- exogenous insulin injections
Type 2
- Non-insulin dependant
- adult onset
- hyperglycemia
- tx: oral medications, insulin
Reversed
Diabetes Oral Manifestations
Generally Type 1
- periodontal disease
- xerostomia
- enlargement/erythema of gingiva
- glossitis
- candidiasis
Reversed
Hypercorticism
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
Reversed
Hypoadrenocorticism
Addisons Disease (“addison is skinny”)
- low cortisol levels
- weight loss, weakness, hypotension
- patchy, brown, macular pigmentation in oral cavity
- tx: prednisone (corticosteroid)
Reversed
Thyroid Gland
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
Reversed
Melanocytic Nevus
- Nevus: mole or birthmark
- benign tumor of melanocytes
- on hard palate, buccal mucosa
- genetic predisposition
Reversed
Lipoma
benign tumor of mature fat cells
- yellow mass on buccal mucosa and vestibule
Reversed
Frictional Keratosis
hyperkeratosis of epithelium caused by friction against tissue
- white
- nonmalignant
- resembles leukoplakia (monitor)
Reversed
Fibroma
most common tumor in oral cavity
reactive hyperplasia of connective tissue
along bite lines, smooth surfaces
asymptomatic
Reversed
Osteosarcoma
Malignant tumor of bone-forming tissue
Sunburst pattern
teens and elders effected
Reversed
Aspirin Burn
white necrotic tissue that may slough off
- painful
- caused by aspirin tablet placed on gingiva instead of swallowing
- heals in 7-10 days spontaneously
Reversed
Cherubism
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
Reversed
Solar (actinic) Cheilitis
pre-cancerous, related to sunday exposure
fair-skinned individuals
lower lip and vermillion boarder most affected
Reversed
Verrucous Carcinoma
diffuse, painless, thick plaque
- slow growing
- leukoplakia, tobacco pouch keratosis
- tobacco and HPV are predisposing factors
- metastasis is extremely rare
Reversed
Snuff Dippers Lesion
Smokeless tobacco keratosis
- stretched mucosa appears fissured
- thin grey-white translucent plaque
- severity correlates with quantity of daily use
Reversed
Mucoepidermoid Carcinoma
Most common salivary gland malignancy*
- most common in parotid gland*
- 20-70y/o
- prognosis depends on size of lesion
- low - rarely metastasizes
- high - frequently metastasizes
Reversed
Smokers Melanosis
Dark Pigmentation caused by stimulation of melanin production
Caused by cigarette smoke
- anterior labial gingiva most common
Reversed
Tobacco Pouch Keratosis
Raised flat area most commonly on muccobuccal fold
can disappear in absence of tobacco
may metastasize
Reversed
Epstein-Barr Virus
Hairy Leukoplakia
- white patches that resemble folds, doesn’t wipe off
- usually not malignant
- cancer “Kaposi’s Sarcoma”
Reversed
Denture Stomatitis
Chronic Atrophic Candidiasis
- due to irritation from oral appliances
- tx: remove and clean prosthetics at night, re-size if needed
Reversed
Impetigo
highly contagious skin infection
- Staphylococcus Aureus or Streptococcus Pyogenes
- vesicles resemble herpes
- young children
- fever does not occur
Reversed
Pericoronitis
inflammation and infection between tooth and gingiva
erupting 8’s is most common location
Reversed
Syphillis
*huchinsons incisors and mulberry molars
- caused by Treponema Pallidum
- sexual transmission
- chancre: primary stage, highly infectious
- mucous patch: secondary stage (apx. 6 weeks after chancre), most infectious stage
- gumma: non-infectious third stage
Reversed
Human Papillomavirus (HPV)
Verruca Vulgaris
- warts transmitted through direct contact
- white, papillary, exophytic lesion
Condyloma acuminatum
- benign, pink lesion, papillary projections
- sexually transmitted
Reversed
Exostosis
overgrowth of compact bone on buccal of max/mand
- no tx
- asymptomatic
Reversed
Hematoma
accumulation of blood in tissue due to trauma
dark in colour
Reversed
Lingual Thyroid Nodule
tissues entrapped in tongue
mass on midline, posterior to circumvallate papillae
Reversed
Cyclic Neutropenia
inherited disorder with frequent decrease in neutrophils (2-3days)
- periodontal disease and ulcerations
- treatment only when neutrophil count is normal
Reversed
Ellis-Van Creveld Syndrome
Inherited disorder resulting in dwarfism
- polydactyly, hyperplastic nails
- fusion of gingiva from max anteriors
- lack of incisors, have single tooth in center
- natal teeth
