Papillary Growths Flashcards
List the Infectious/Neoplastic growths
-Verruca Vulgaris
-Squamous Papilloma
List the Infectious growths
Condyloma acuminatum
List the injury growths
Inflammatory papillary hyperplasia
Human Papillomavirus (HPV)
-DS DNA virus
-Infects Epithelial Cells
1. Cutaneous (skin) - face, hands, feet
2. Mucous membranes - oral cavity/head and neck mucosa, anogenital region
- >200 types in humans (>30 types infect oral mucosa)
-Associated with benign, potentially malignant, and malignant epithelial lesions
List the major HIV types associated with oral squamous papilloma
6, 11
List the major HIV types associated with oropharyngeal squamous cell carcinoma
16
List the major HIV types associated with verruca vulgaris
2
List the major HIV types associated with condyloma acuminatum
6, 11
HPV Vaccine is indicated for prevention of
-Genital warts
-Precancers and cancers of uterine cervix, vulva, vagina and anus
-Oropharyngeal and other head and neck cancers
Squamous Papilloma
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Treatment
Category
-Infectious, neoplastic
Etiology
-Benign proliferation of stratified squamous epithelium
-HPV types 6 and 11
Demographics
-Diagnosed most often between 30-50yrs old
Clinical Presentation
-White or pink exophytic nodule with fingerlike surface projections
-Often pedunculated
-Soft palate, tongue, and lips are common oral sites
-Usually single lesion
Diagnosis
-Difficult to differentiate from verruca vulgaris, condyloma acuminatum, and others clinically
Tx
-Excisional biopsy
Verruca Vulgaris
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
“Common Wart”
Category
-Infectious, neoplastic
Etiology
-Benign hyperplasia of stratified squamous epithelium
-HPV type 2
-Contagious
Demographics
-Most common in children
Clinical Presentation
-Painless papule with papillary projections or rough, pebbly surface
-Can have multiple or clustered lesions
-Skin of the hands most common
-Vermilion border, labial mucosa, and anterior tongue most common oral sites
Diagnosis
-Clinical diagnosis
-Biopsy
Tx
-Can resolve spontaneously (2/3 resolve within 2 yrs)
-Topical salicylic acid
-Cryotherapy
-Surgical excision (first line treatment for oral lesions)
Condyloma Acuminatum
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category
-Infectious
Etiology
-Proliferation of stratified squamous epithelium
-HPV types 6 and 11
-Contagious
-Common sexually transmitted disease
Demographics
-Often teenagers and young adults
Clinical Presentation
-Most commonly anogenital
-Oral lesions most frequently on labial mucosa and lingual frenum
-Sessile, pink, exophytic mass with short, blunted surface projections
-Tend to be larger than squamous papillomas
-May be single or clustered
Diagnosis
-Biopsy
Tx
-Excisional biopsy
-Cryotherapy and laser ablation also used
Inflammatory Papillary Hyperplasia
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category
-Injury
Etiology
-Ill-fitting denture
-Poor denture hygiene
-Wearing denture 24hrs/day
-Candidiasis?
Demographics
-Denture or retainer wearer (usually)
-Can occur in patients with high palatal vault and mouth breathers
Clinical Presentation
-Usually asymptomatic
-Erythematous pebbly or papillary mucosa
-Midportion of hard palate most frequently affected
Diagnosis
-Clinical
-Biopsy if any dount
Tx
-Improve denture hygiene/remake ill-fitting denture
-Topical and/or systemic antifungal
List other important diagnoses that may appear papillary
-Proliferative verrucous leukoplakia
-Squamous cell carcinoma
-Verrucous carcinoma
*These are generally going to show more persistent, continuous growth and will grow bigger than most HPV lesions
What is the gold standard for accurate diagnosis?
BIOPSY!
