Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5th Oral Disease -Histology Lectures > Pigemented Lesions > Flashcards

Pigemented Lesions Flashcards

1
Q

What are 4 main sources of pigment

A
  1. Melanin
  2. Haemosiderin
  3. Heavy metals
  4. Chromogenic bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is melanin produced?

A

Produced by melanocytes or nevus cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a nevus cell?

A

Modified melanocyte found in moles of skin/ mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do melanocytes produce and distribute melanin?

A

Has dendritic processes - distribute melanin to adjacent cells

Malansoma distributed to basal cells

Melanin transferred adjacent keratinocytes via membrane bond organelles = melanomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is increased melanin production worrying?

A

Increased production w/o increased number of melanocytes

Can only see melanocytes when abnormal change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is haemosiderin?

A

Break down of RBCs

Haem component = iron stored
Iron can be stored as hemosiderin in cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What heavy metals can cause pigmented lesions?

A

Bismuth, mercury, silver, arsenic, gold

Drugs w/ heavy metal e/g pepto-bismol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does pepto-bismol cause heavy metal leaching?

A

Combined w/ sulphur in saliva = bismuth sulphide which is insoluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examples of occupational exposure to heavy metals?

A

Manufacture of ammunition, dental x-ray film

Lead miners, plumbers, mechanics, welding etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is argyria?

A

Exposure to excess silver

e.g colloidal silver ingestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are chromogenic bacteria?

A

Bacteria that produce pigement

Bacterial enzymes act on iron in saliva - produce salts = pigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Give examples of chromogenic bacteria?

A

Aspergillus and actinomyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What condition is often associated w/ chromogenic bacteria?

A

Hairy tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Difference between exogenous and endogenous lesions?

A

Exogenous - amalgam tattoo, foreign body tattoo, black hairy tongue

Endogenous - developmental, acquired and neoplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examples of developmental pigmented lesions?

A

Physiological - melanin
Peutz Jehger’s syndrome
Haemochromatosis
Pigemented naevus - melanin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Examples of acquired pigmented lesions?

A 
Addison's disease
Drug induced
Post-inflammatory 
Smoker's melanosis 
Melanotic macule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Example of neoplastic lesions?

A

Melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What info is needed to make differential diagnosis?

A 
Age
Occupation
Hx of lesion
MH, DH, DH, SH, FH
Extra and intra-oral examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is needed to diagnose an amalgam tattoo?

A

Silver/ grey often associated w/ adjacent tooth

Radiograph - can confirm amalgam

Biopsy - if lesion not classic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What to consider if amalgam tattoo in area with no tooth?

A

Associated tooth may have been XLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of amalgam tattoo?

A 
Low grade leaching 
Deep class II - amalgam pushed into PDL 
XLA - amalgam fall into XLA socket
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What would histology of amalgam tattoo show?

A

Show black pigment in connective tissue

Amalgam runs along collagen fibres around blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does histology of heavy metal lesions differ from amalgam tattoos?

A

Same histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Who and where would you see black hairy tongue?

A

Posterior dorsum of tongue

Soft diet, smoking, ab use

25
Q

How does black hairy tongue happen?

A

Decrease in normal desquamation process
Elongated filiform papilla (white/brown/black)
Discolouration by chromogenic bacteria, chlorhexidine, foods, smoking

26
Q

Tx of black hairy tongue?

A

Reassurance
Tongue scraper - reduce length filiform papillae
Smoking cessation

27
Q

What are physiological pigmented lesions?

A

See increased melanin in the gingiva

Normal physiological pigment - often present since birth

28
Q

What is Peutz-Jeghers?

A

Autosomal dominant genetic disorder

See pigmented mucocutaenous macule, GI polyps, SI w/ increased risk of malignant change

29
Q

How to melanotic spots appear in those w/ PJ?

A

Characteristically small and multiple
Very obvious around lips
Large pigmented freckles - skin and mucosal membrane

30
Q

Why do those w/ suspected PJ need to be refereed early?

A

Increase risk of carcinoma

31
Q

What histology would you see w/ PJ?

A

Increase melanin - see in basal cell layer excess melanin

32
Q

What is haemochromatosis?

A

Autosomal recessive genetic disorder

Causes accelerated rate of intestinal iron absorption = raised serum ferritin and transferrin saturation = accumulation of iron

33
Q

What do you see in haemochromatosis

A

Bronze skin pigment

34
Q

What population more likely to see hameochromatosis?

A

Celtic population

35
Q

How to tx Haemochromatosis

A

Regular venesection - hard for body to excrete iron

36
Q

What is melanin?

A

Synthesised by naevus cells derived from neural crest

Sound in skin and mucosa

37
Q

What are histological types of naevus cells?

A

Junctional - epithelium
Inderdermal/ mucosal - CT
Compound - both

38
Q

What is Addisons disease?

A

Autoimmune condition affecting adrenal gland = destruction of adrenal cortex

39
Q

In Adddisons disease what does destruction of adrenal cortex cause?

A

Lack of adrenocortical hormone = increase ACTH produced by anterior pituitary

40
Q

What does excess ACTH in Addisons disease cause?

A

ACTH induce melanocyte-stimulating hormones = pigmentation of skin and oral mucosa

41
Q

What do you see in Addisons disease?

A

Diffuse brown patch on buccal mucosa, palate, tongue and gingivae

Extra-oral: palmar creases

42
Q

Histology of Addisons disease?

A

Increase melanin pigment in basal keratinocytes w/ no alteration to melanocytes

43
Q

What are melanotic macule?

A

Can occur anywhere in mouth

Similar to those seen in PJ but not associated w/ syndrome

44
Q

What would see in biopsy of melanotic macule?

A

Excess melanin in basal portion but no increase melanocytes

45
Q

What drugs can cause pigmented lesions?

A 
Antimalarial - chloroquine/ hydroxychloroquine 
Birth control pills
Ketoconazole 
Tetracycline/ minocycline
Doxorubicin (chemo-medication)
46
Q

What do you see in drug induced pigmented lesions?

A

Increase production of melanin
Deposition of iron after damage to mucosal vessel
Deposition of heavy metal in skin

47
Q

What are post-inflammatory pigmented lesions?

A

Usually people with darker skin
Inflammatory insult = melanin accumulating

Basal cell layer damage = melanin drop into lamina proprietary

48
Q

Why can see post-inflammatory pigmented lesion in lichen planus?

A

Lymphocytes damage overlying mucosa

Melanocytes respond by producing melanin

49
Q

What does smoking do to melanocytes?

A

Stimulate melanocytes = excess melanin

50
Q

What is malignant melanoma?

A

Proliferation of malignant melanocytes along junction between epithelium and connective tissue and in CT

51
Q

Where does malignant melanoma present orally?

A

Palate

52
Q

Which gender does malignant melanoma affect more?

A

Men > women

53
Q

How does malignant melanoma present?

A

Asymptomatic, slow growing black or brown patch w/ asymmetric and irregular borders

Can be rapidly enlarging and associated w/ ulceration, bleeding, pain and bone destruction

Can be non-pigmented

54
Q

Tx of malignant melanoma?

A

Radical surgical excision w/ clean margins

Radiation and chemotherapy often ineffective

55
Q

Problem w/ malignant melanoma?

A

5-year survival = 15%

Agressive and fatal

56
Q

What is Kaposi sarcoma?

A

Malignant tumour
Hallmark of AIDS
Caused by HHV-8

57
Q

How does Kaposi sarcoma present?

A

Black/ purple lesions orally

Gingivae commonly affected

58
Q

Is Kaposi sarcoma a pigmented lesion?

A

Partially, haemosiderin gives brown colour

Vascularity gives red/blue colour

59
Q

Tx of Kaposi sarcoma?

A

Excision +/- chemotherapy/ radiotherapy

5th Oral Disease -Histology Lectures (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions