Pre-malignant conditions and lesions Flashcards

1
Q

What is Oral Submucous Fibrosis?

Who is it most prevalent in?

A

Fibrosis of oral mucosa and difficulty opening mouth

Paan, betel chewers

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2
Q

At what age is leukoplakia most prevalent?

A

Middle aged (increasing prevalanece with age)

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3
Q

Define pre-malignant lesion

A

Morphologically altered tissue in which cancer is more likely to occur than in its normal counterpart

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4
Q

What type of pre-malignant oral condition is linked to syphillis?

A

Leukoplakias on central dorsum of tongue (rare)

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5
Q

What is the most common cause of leukoplakia?

A

Tobacco use (90%)

Other 10% idiopathic (spontaneous)

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6
Q

What are fordyce spots?

A

Enlarged, slightly raised sebaceous (oil) glands that appear in hairless areas of your skin

Purely anatomical no issues

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7
Q

What clinical feature relating to the colour of a luekoplakia lesion is suggestive of an increased risk of malignant transformation?

A

Increased if red / white (speckled)

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8
Q

What are common sites of leukoplakia?

A

Buccal mucosa (25%)
Mandibular gingivae (20%)
Tongue (10%)
FoM (10%)

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9
Q

How should you manage a patient that has lichen planus?

What would you do if the lesion develops the following; increased whiteness, speckling (red & white) or solitary ulceration?

A

Pt should be kept under regular review by GDP

Further specialist opinion & possible biopsy

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10
Q

What two things are needed for a leukoplakia diagnosis?

A

Leukoplakia diagnosis can only be made after careful clinical examination & biopsy (of area including both normal & affected tissue)

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11
Q

What advice should you give to patients with oral lichen planus?

A

Should be advised of controversial malignant potential

Avoid tobacco & alcohol
Have diet rich in Vit A, C & E / anti-oxidants
Maintain good OH

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12
Q

Which sex is more affected by leukoplakia?

A

Male > Female

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13
Q

What is White sponge nevus?

A

Benign devolmental white spot lesions in oral mucosa

Confirmed by biopsy

As benign no tx needed

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14
Q

What are some benign white spot lesions caused by trauma?

A

Frictional keratosis
Cheek biting
Trauma

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15
Q

What sites of a luekoplakia lesion are suggestive of an increased risk of malignant transformation?

A
  • Floor of mouth
  • Lateral border of tongue
  • Retromolar region
  • Buccal sulcus (paan chewers)
  • Labial Commissure
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16
Q

Describe the appearance of homogenous luekoplakia

A
  • Uniform flat appearance or wrinkled surface (shallow cracks)
  • Smooth, wrinkled or corrugated surface with consistent texture throughout
17
Q

Describe the appearance of non-homogenous luekoplakia

A
  • Predominantly white or white & red lesion (speckled erythroleukoplakia)
  • Irregularly flat, nodular & exophytic (outwardly growing)

Nodular - Raised, rounded, red and/or white excrescences
Exophytic - Irregular blunt or sharp projections

18
Q

What type of infection causes oral hairy leukoplakia?

A

EBV

19
Q

What clinical features of the surface of a luekoplakia lesion are suggestive of an increased risk of malignant transformation?

A

Increased risk if raised or nodular

20
Q

What is leukoplakia?

A

White patches of questionable risk, having excluded other known diseases or disorders which carry no increased cancer risk

(leuko=white, plakia=patch)

21
Q

What is the most common cause of leukoplakia?

A

Tobacco use (90%)

Other 10% idiopathic (spontaneous)

22
Q

Define pre-malignant condition

A

Generalised state associated with a significantly increased risk of developing cancer

23
Q

What is the appearnce of erythroplakia?

Comment on malignancy risk

A

Bright red, velvety plaque which cannot be characterised as any other definable lesion/disease

High risk lesions ALWAYS associated with dysplasia or carcinoma

Rate of Malignant Change: 80%