white and red patches Flashcards
what are the 8 questions you need to answer when examining a white or red patch?
- size?
- site?
- Texture?
- Duration?
- Localised?
- Multiple?
- associated with systemic symptoms/ signs?
- Treatment?
what is a leukoplakia?
a white patch plaque of questionable risk with no other histological diagnosis
what is the prevalence of leukoplakia?
prevalence - 1-2%
(increased x6 by smokers)
what is the appearance of leukoplakia?
> speckled
verrucous
the more unusual the appearance the more likely there is some dysplastic
what is erythroplakia?
red patch, velvet type appearance not histologically confirmed as any other condition
what are the key points on erythroplakia?
> high rate of malignant transformation >80%
high rate of dysplastic change at biopsy
urgent sampling required
what are the 8 risk factors for progression red/ white patches?
- female gender
- long duration of leukoplakia
- leukoplakia in non smokers (idiopathic leukoplakia/ drinkers (synergy
- location on the tongue and/ or floor of the mouth
- non-homogenous type
- presence of candida
- size >200mm2
- presence of epithelial dysplasia
what is an ulceration?
a break in the oral mucosa
what are the possible causes of an ulcer?
congenital
acquired
vascular
infective
traumatic
autoimmune
metabolic
neurological
neoplastic
degenerative
environmental
unknown
what are the 5 descriptors for ulcer examinations?
- SIZE : RAS : minor, major, hepetiform v large erosive areas
- EDGES : smooth, kerototic, or ragged
- SHAPE : regular or irregular
- BASE : fibrinous or otherwise
- MARGIN : regular or rolled and raised
what is RAS?
Recurrent aphthous stomatitis (RAS), or what is commonly referred to as “canker sores”, is a form of benign inflammation of the mouth.
what are 5 common things to watch out for with ulcers?
- ulcerations on the edge of tongue, buccal mucosa with keratitis edges
- RAS - history of starting young age regular margins, transient nature
- minor, major, hepetiform
- watch out for non healing long standing ulcers
- older populations generally do not develop RAS therefore what is driving this?
what special investigations would you take?
> full blood count
(Hb, Hct, MCV, Pt, WBC, neutrophils)
what is anaemia?
low Hb
small cells - microcytic
big cells - macrocytic
normal cells - normocytic
what is microcytic anaemia ?
> mean corpuscular volume of less than 80 micro m3
normally deficient in iron
other causes include thalessemia and chronic disease
