Premalignant epithelial lesions (test 1) Flashcards
What is a leukoplakia?
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
What do you do with a leukoplakia?
mandatory biopsy
What can you do if you see a leukoplakia like something in the mouf to aid in your differential diagnosis?
Try and wipe it off.
What is a speckled leukoplakia?
It’s a leukoplakia with a red component present
What are the high risk sites for leukoplakias?
ventral tongue, floor of mouth, tonsillar pillars
What is a sanguinary-associated leukoplakia and where is it found?
It’s only found in people who have used viadent toothpaste or mouthwash. The leukoplakia is found on the maxillary buccal gingiva and vestibule
Histology time: what are we going to see with a leukoplakia?
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
How do you treat a leukoplakia?
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”
What is the prognosis for a leukoplakia?
Guarded.
15% of non-dysplastic lesions will transform
33% of dysplastic lesions will transform
30% of leukoplakia will recur
What is an erythroplakia?
A velvety red, well demarcated patch that cannot be diagnosed as any other condition clinically or microscopically
Which is worse- erythroplakia or leukoplakia?
erythroplakia
Where are erythroplakia’s found?
lateral tongue, floor of mouth, soft palate
What percentage of erythroplakias have severe epithelial dysplasia or worse?
90%
Fun fact- erythroplakias are red because they don’t have any keratin at the surface of the lesion.
Cool.
T/F Erythroplakias have a similar prognosis to leukoplakias?
Truth
What is actinic keratosis and what causes it?
premalignant sun-induced skin lesion.
Where is actinic keratosis usually found?
Facial skin and vermillion zone of the lips (especially in fair skinned persons over 40 years old)
What is the actinic keratosis made of?
It’s a hyperkeratosis, usually parakeratin
Actinic keratosis is treated by liquid nitrogen, surgical excision, laser ablation, 5 fluoro-uracil or imiquimod
Prognosis is fair to good but pts. must be monitored for development of new lesions
What is actinic cheilosis/cheilitis?
It is when you have actinic keratosis on the vermillion zone of the lower lip
What does actinic cheilitis look like?
There is chronic scaling, crusting, ulceration, and/or fissure of the lip
How do you treat actinic cheilosis?
You do a vermillionectomy- chop their lip off!
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.
So who knows what’s going on with all that