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Prof Thomson > Week 2- OPMD's > Flashcards

Week 2- OPMD's Flashcards

1
Q

What are the 2 types of OPMD’s?

A
  • Discrete mucosal lesions
  • Widespread conditions
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2
Q

What is the definition of a discrete mucosal lesion OPMD?

A

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

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3
Q

What is leukoplakia?

A

White patch which cannot be wiped off the mucosa or ascribed to any other clinical or histo-pathological condition; by definition it has a potentially malignant predisposition

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4
Q

Why does leukoplakia appear white?

A

Hyperkeratinisation

Keratin absorbs saliva

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5
Q

What is the estimated prevalence of leukplakia?

A

1.7-2.7%

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6
Q

What are characteristics of proliferative verrucous leukoplakia?

A
  • Slow growing
  • Multi-focal leukoplakia
  • Fissured, exophytic, warty-looking
  • Older females
  • Not associated with tobacco and alcohol
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7
Q

What can proliferative verrucous leukoplakia be dismissed as?

A

Frictional hyperkeratosis

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8
Q

What is the transformation rate of proliferative verrucous leukoplakia?

A

70%

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9
Q

What is erythroplakia?

A

Well-defined, velvety-red, depressed patch most common in FOM. 40% are already invasive SSC.

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10
Q

What is erythroleukoplakia?

A

White flecks or nodules on atrophic erythematous base

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11
Q

Where can erythroleukoplakia be found?

A

FOM, buccal mucosa, labial commissures

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12
Q

What is oral submucous fibrosis and why is it at increased risk of malignant transformation?

A

Rx to areca nut chewing. There is thickened collagen laid down in sub mucosa which gives rise to trismus. Oral epithelium becomes atrophic which increases risk of malignant transformation.

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13
Q

What 3 oral diseases are associated with iron deficiency?

A

Plummer-Vinson Syndrome

Sideropaenic Dysphagia

Peterson-Kelly-Brown Syndrome

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14
Q

How should chronic hyperplastic candidosis be treated? Why?

A

Treat with systemic antifungals.

Topical anti-fungals don’t work as candida hyphae extend 2/3 of depth through epithelium and therefore won’t penetrate that far. Need systemic antifungals to reach it (fluconazole 50mg once a day for 7 days).

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15
Q

What are characteristics of discoid lupous erythematosus?

A

Butterfly rash across cheeks. Subtle star shaped erosions and redness.

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16
Q

What is this disease?

A

Actinic Cheilitis

17
Q

What are characteristics of lichen planus?

A
  • Mucocutaneous disorder
  • Rashes on legs and arms
  • Lace-like white patterns and hyperkeratosis
  • Sometimes erosions and atrophy on mucosa
18
Q

What lichenoid lesions are high risk vs not high risk for malignant transformation?

A
  • Isolated lichenoid lesions on tongue- high risk for malignant transformation.
  • Classic bilateral mucocutaneous lichen planus- not high risk for malignant transformation
19
Q

What is this disease?

A

Tertiary Syphilis

20
Q

What is the malignant transformation rate?

A

12%

21
Q

What are high risks of malignant change?

A
  • Floor of Mouth, Ventro-Lateral Tongue, Retromolar Regions
  • Erythroplakia and Erythroleukoplakia
  • Nodular (non-homogeneous) Leukoplakia
  • Larger Lesions
  • Non-Smokers, Females, Older Patients
  • ‘High Grade’ Dysplasia
22
Q

What are management goals for OPMD’s?

A
  • Accurate Diagnosis
  • Prediction of Clinical Behaviour
  • Early Recognition of Malignancy
  • Removal of Dysplastic Mucosa
  • Prevention of Recurrence
  • Prevent Malignant Transformation
  • Minimal Patient Morbidity
23
Q

What is the best treatment for OPMDs?

A

Surgical intervention (laser, cryotherapy, scalpal, photodynamic therapy)

24
Q

What are benefits of CO2 Laser Surgery?

A
  • Rapid precise dissection
  • Reduced scarring
  • Good pt acceptance
  • Low morbidity
  • Post-op analgesia
  • Haemostasis
  • Facilitates histopathological diagnosis
25
Q

Why is surgical excision a better treatment modality to clinical observation and medical tx?

A
  • Accurate diagnosis
  • Prediction of clinical behaviour
  • Early recognition of malignancy
  • Removal of dysplastic mucosa
  • Prevent further OPMD or malignant transformation
  • Minimal pt morbidity

Prof Thomson (6 decks)

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