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Oral Pathology module 7 > Ulcerated lesions > Flashcards

Ulcerated lesions Flashcards

1
Q

what is an ulcer

A

localised surface defect with loss of epithelium exposing underlying inflamed tissue

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2
Q

causes of ulcers

A

infective
traumatic
drugs
idiopathic
associated with systemic or dermatological disease
neoplastic

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3
Q

viruses that can cause ulceration

A

Herpes simplex virus
varicella zoster virus
cytomegalovirus
coxsackie

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4
Q

drugs that can cause ulceration

A

nicorandil
NSAIDs

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5
Q

idiopathic cause of ulceration

A

recurrent aphthous stomatitis

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6
Q

ulceration associated with systemic disease

A

haematological disease
GI disease
HIV

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7
Q

ulceration associated with dermatological disease

A

lichen planus
discoid lupus erythematosus
ummunobullous diseases

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8
Q

neoplastic ulceration

A

oral squamous cell carcinoma

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9
Q

what is a vesicle

A

small blister

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10
Q

what is a bulla

A

blister over 10mm

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11
Q

when does a vesiculobullous lesion usually present as oral ulceration

A

following rupture of vesicles/bullae

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12
Q

what is a subset of lesions known as

A

immunobullous disorders

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13
Q

how are disorders which result in vesicles/bullae classified

A

depending on the location of the bulla

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13
Q

what are immunobullous disorders

A

autoimmune diseases in which autoantibodies against components of skin and mucosa produce blisters

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14
Q

classification of disorders which result in vesicles/bullae

A

intraepithelial
sub epithelial

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15
Q

subgroup of intraepithelial disorders which result in vesicles/bullae

A

non-acaztholytic (death and rupture of cells) e.g. viral infection
acantholytic (desmosomal breakdown)

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16
Q

example of intraepithelial - non acantholytic virus

A

Herpes simplex virus

17
Q

example of intraepithelial - acantholytic lesion

A

pemphigus

18
Q

what is pemphigus

A

group of autoimmune diseases that affect the skin and mucous membranes

19
Q

pemphigus vulgarise what happens to bullae

A

bullae form in skin and mucous membranes then rupture to leave ulcers

20
Q

treatment of pemphigus vulgarisms

A

steroids

21
Q

Histopathology of pemphigus vulgaris

A

characteristic intraepithelial bullae produced by acantholysis

22
Q

what is used to confirm diagnosis of pemphigus vulgaris

A

direct immunofluorescence (DIF) in conjunction with routine histopathology

23
Q

what is mandatory for direct immunofluorescence

A

fresh specimen

24
Q

sub epithelial examples

A

pemphigoid
erythema multiform
dermatitis herpetiformis
epidermolysis bulls acquisita

25
Q

groups of pemphigoid

A

bullous
mucous membrane
linear IgA disease
drug induced

26
Q

where is usually the first affected site in mucous membrane pemphigoid

A

oral mucosa

27
Q

how do gingival lesions present as in mucous membrane pemphigoid

A

desquamative gingivitis

28
Q

how do bullae present in mucous membrane pemphigoid

A

tend to be relatively tough as the ‘lid’ is full thickness epithelium

29
Q

treatment of mucous membrane pemphigoid

A

steroids

30
Q

histopathology of mucous membrane pemphigoid

A

separation of full thickness epithelium from connective tissue producing subepithelial bulla with a thick roof

31
Q

what do you use to confirm diagnosis of mucous membrane pemphigoid

A

direct immunofluorescence (DIF) in conjunction with routine histopathology

32
Q

what is epidermolysis bulls acquisita

A

acquired autoimmune blistering dermatosis with sub epithelial bullae

33
Q

percentage of epidermolysis bulls acquisita presenting with oral lesions

A

50%

34
Q

what might early and late stage epidermolysis bullosa acquisita mimic

A

early - pemphigoid
late - epidermolysis bulls

35
Q

what is epiedermolysis bullosa

A

group of rare genetic conditions
formation of skin bullae which heal with scarring

36
Q

3 variants of epidermolysis bullosa

A

simplex
junctional
dystophic

37
Q

what are oral blood blisters also known as

A

angina bullosa haemorrhagica

38
Q

what happens with oral blood blisters

A

spontaneous blood filled bullae, burst to form ulcers and heal uneventfully

39
Q
A

Oral Pathology module 7 (8 decks)

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