OS - benign mucosal lesions Flashcards
what is the surgical sieve?
congenital
traumatic
autoimmune
metabolic
infective
inflammatory
idiopathic
what are types of congenital benign mucosal lesions? and what do they look like?
leukoedema - white/grey discolouration of mucosa
fordyce spots - ectopic sebaceous glands
where do you commonly find leukoedema?
buccal mucosa - an area that would not tend to be traumatised by teeth
where do you commonly find fordyce spots?
buccal mucosa or lips
list types of traumatic benign mucosal lesions?
erosions/ ulcers
frictional keratosis
polyps
denture induced hyperplasia
amalgam tattoos
mucocoeles
what can cause traumatic ulcers?
dentures
restorations
direct trauma
how are traumatic ulcers treated?
irradicate the source
should resolve within 14 days
how common are aphthous ulcers?
20% population
what are the causes of aphthous ulcers?
genetic
trauma
food stuffs
haematinic def - ferritin, folate, B12
hormonal
what types of trauma can cause ulceration?
mechanical - adjacent restorations
thermal - hot food
when would you see a keratotic margin around an ulcer?
chronic trauma which is low grade i.e., frictional keratosis
what are clusters of aphthous ulcers called?
herpetiform aphthous ulcers
what is the name for cheek biting?
morsicatio buccarum
where do you find linea alba? and what does it look like?
white line at level of occlusal plane on buccal mucosa
bilateral
what are polyps?
benign growths form in the mucosa
they can be:
- pedunculated (small stop)
- sessile (broad based)
normal mucosa overlying with fibrous centre
when would you excise a polyp?
if they get too big that the pt cannot help biting
what is an amalgam tattoo and where would you find them?
metal inclusions in the mucosa from an amalgam being removed or replaced
why must you biopsy an amalgam tattoo?
looks similar to mucosal melanoma
why would someone get denture induced hyperplasia?
ill fitting dentures worn 24/7
what does denture induced hyperplasia look like?
polyps that grow around flange of denture
treatment for denture induced hyperplasia?
excision and new dentures
what can denture induced hyperplasia superimpose?
candida infection
what is a mucocele?
minor salivary gland cyst (mucous extravasation cyst)
what causes a mucocele?
saliva escapes from the damaged duct into the surrounding lip and causes a swelling
commonly due to trauma to lower lip
treatment for mucocele?
excision of the mucocele and salivary gland
what are the types of fungal benign mucosal lesions?
acute pseudomebranous candidiasis
candidal leukoplakia
what are the types of viral benign mucosal lesions?
human papilloma virus
herpes virus
how does candidiasis present?
white plaques that wipe free leaving a red base
how do you treat candidiasis?
systemic antifungals
topicals but not as good
what does candidal leukoplakia present as?
white/ red lesion does not wipe free
how do you treat candidal leukoplakia?
systemic antifungals and biopsy
how do papillomas present?
sessile or pedunculated
finger like
what is treatment of papillomas?
if become too big or traumatised
excision including the base of the lesion
what is secondary herpes caused by?
reactivation of latent virus in the trigeminal system by UV light, stress, hormones, immunocompromise
symptoms of secondary herpes?
tingling sensation before vesicles develop on the lip
treatment of secondary herpes?
cold sore treated with topical antivirals
types of inflammatory benign lesions?
geographic tongue
lichenoid reaction
epulis
how common is geographic tongue?
2-3% population
cause of geographic tongue?
family history
psoriasis
fissured tongue
vit B problems
what is another term for geographic tongue?
benign migratory glossitis
how is symptomatic geographic tongue treated?
LA or steroid mouthwash
what is a lichenoid lesion? and what causes it?
reaction to metal (contact lesions) or medication:
- antihypertensives
- hypoglycaemics
- NSAIDs
how do you treat lichenoid lesions?
biopsy to establish diagnosis
what is an epulis?
growth on the gum
what are the types of epuli?
fibrous epulis
pyogenic granuloma
what is a fibrous epulis and what is it associated to?
associated with the gingival margin of teeth
caused by chronic irritation by overhanging enamel or restorations
normal overlying mucosa and fibrous centre
treatment of fibrous epulis?
excision
what is a pyogenic granuloma and what is it associated with?
associated with gingival margin of teeth
very vascular
associated with pregnancy
treatment of pyogenic granuloma?
excision
what metabolic disease can affect pigmentation of mucosa in the mouth and why?
addisons disease
primary adrenal insufficiency
deficiency of cortisol and aldosterone
what is a melanotic macule? and what does it look like?
round or oval
brown or black
pigmented area on the lip or any mucosal surface
aetiology of melanotic macule?
trauma or idiopathic
50+ years old
melanotic macule treatment?
biopsy for diagnosis
excision for aesthetics
what are types of autoimmune benign mucosal lesions?
lichen planus
vesiculobullous conditions
how does lichen planus present?
lacy white pattern
what are types of vesiculobullous conditions?
pemphigus
pemphagoid
give an example of an idiopathic lesion of unknown aetiology?
lipoma
what are lipomas?
benign mesenchymal neoplasms of unknown cause, made up of fat cells surrounded by a thin fibrous capsule
treatment of lipoma?
excision
