Premalignant epithelial lesions (test 1)

Question 1

What is a leukoplakia?

Answer 1

It’s a sharply demarcated white plaque with smooth, verrucous, or micronodbular surface found on the oral mucosa that can’t be scraped off and can’t be diagnosed clinically or microscopically as any other condition

Question 2

What do you do with a leukoplakia?

Answer 2

mandatory biopsy

Question 3

What can you do if you see a leukoplakia like something in the mouf to aid in your differential diagnosis?

Answer 3

Try and wipe it off.

Question 4

What is a speckled leukoplakia?

Answer 4

It’s a leukoplakia with a red component present

Question 5

What are the high risk sites for leukoplakias?

Answer 5

ventral tongue, floor of mouth, tonsillar pillars

Question 6

What is a sanguinary-associated leukoplakia and where is it found?

Answer 6

It’s only found in people who have used viadent toothpaste or mouthwash. The leukoplakia is found on the maxillary buccal gingiva and vestibule

Question 7

Histology time: what are we going to see with a leukoplakia?

Answer 7

usually some degree of hyperkeratosis, often sharply demarcated from normal epithelium, some epithelial dysplasia may be seen, mild, moderate, severe or even carcinoma in situ

Question 8

How do you treat a leukoplakia?

Answer 8

Well, if there is no or mild dysplasia watch it and discontinue carcinogenic habits.
IF there is moderate dysplasia or worse, remove the leukoplakia “by the most convenient means available”

Question 9

What is the prognosis for a leukoplakia?

Answer 9

Guarded.
15% of non-dysplastic lesions will transform
33% of dysplastic lesions will transform
30% of leukoplakia will recur

Question 10

What is an erythroplakia?

Answer 10

A velvety red, well demarcated patch that cannot be diagnosed as any other condition clinically or microscopically

Question 11

Which is worse- erythroplakia or leukoplakia?

Answer 11

erythroplakia

Question 12

Where are erythroplakia’s found?

Answer 12

lateral tongue, floor of mouth, soft palate

Question 13

What percentage of erythroplakias have severe epithelial dysplasia or worse?

Answer 13

90%

Question 14

Fun fact- erythroplakias are red because they don’t have any keratin at the surface of the lesion.

Answer 14

Cool.

Question 15

T/F Erythroplakias have a similar prognosis to leukoplakias?

Answer 15

Truth

Question 16

What is actinic keratosis and what causes it?

Answer 16

premalignant sun-induced skin lesion.

Question 17

Where is actinic keratosis usually found?

Answer 17

Facial skin and vermillion zone of the lips (especially in fair skinned persons over 40 years old)

Question 18

What is the actinic keratosis made of?

Answer 18

It’s a hyperkeratosis, usually parakeratin

Question 19

Actinic keratosis is treated by liquid nitrogen, surgical excision, laser ablation, 5 fluoro-uracil or imiquimod

Answer 19

Prognosis is fair to good but pts. must be monitored for development of new lesions

Question 20

What is actinic cheilosis/cheilitis?

Answer 20

It is when you have actinic keratosis on the vermillion zone of the lower lip

Question 21

What does actinic cheilitis look like?

Answer 21

There is chronic scaling, crusting, ulceration, and/or fissure of the lip

Question 22

How do you treat actinic cheilosis?

Answer 22

You do a vermillionectomy- chop their lip off!

Question 23

Just a disclaimer- the last 20 slides or so of this lecture are pictures and she talked about a lot of stuff on there that we haven’t learned about IE geographic tongue.

Answer 23

So who knows what’s going on with all that