White Lesions Flashcards
Most common oral precancerous lesion
Leukoplakia
Leukoplakia most commonly found on
Lip vermilion, buccal mucosa, gingiva
Which area’s leukoplakia show highest chances of dysplasia
Tongue, floor of the mouth
Variants of leukoplakia
Homogenous (most common), granular, speckeled, verrucous
Which type of leukoplakia has highest risk of malignant transformation to Squamous cell carcinoma
Proliferative verrucous leukoplakia
Hyperchromatism, pleomorphism, dyskeratosis
Leukoplakia
Which gender shows high risk of malignancy from leukoplakia
Female
Benign white lesion associated with HIV pts, can occur in immunosuppressed pts
Hairy leukoplakia
Cause for hairy leukoplakia
Epstein-Barr virus
Wrinkled in vertical direction, white asymptomatic patch, bilaterally on lateral surface of tongue
Hairy leukoplakia
Chronic inflammatory mucocutaneous, T cell mediated
Lichen planus
Looks like lichen planus but caused by dental material, stress, medications
Lichenoid mucositis
Most common types of lichen planus
Reticular, erosive
On skin purple, pruritic, polygonal, papules on flexor surface of extremities, genital mucosa, nails
Lichen planus
Common location for lichen planus
Buccal mucosa bilaterally
Most common form of lichen planus
Reticular
Asymptomatic bilateral white papules connect and form network
Reticular lichen planus
Wickham Striae
Lichen planus
Erosive lichen planus only affecting gingiva
Desquamative gingivitis
Erythematous, atrophic areas with central ulceration bordered by thin,white radiating striae
Erosive lichen planus
Symptomatic form of lichen planus
Erosive
Saw tooth appearance of rete pegs, degeneration of basal cell layer Hydropic degeneration
Lichen planus
Civatte bodies, hyaline bodies
Lichen planus
Bandlike infiltration of inflammatory cells
Lichen planus
Common sequela of pts who undergo allogenic bone marrow transplantation
Graft-versus-host disease
Features minic to sjorgan’s syndrome, SLE and scleroderma
Chronic GVHD
Fine reticular network of white striae that mimic oral lichen planus
Graft-versus-host disease
Bone marrow transplant pts have increased risk for
Epithelial dysplasia, squamous cell carcinoma
To prevent GVHD pts preparing for BMT undergo
T cell depletion of graft & prophylactic tx with immunosuppresants
Form of keratosis on hard palate due to heat of pipe/cigar smoking
Nicotine Stomatitis
Palatal mucosa diffusely gray or white with numerous slightly elevated papules
Nicotine stomatitis
Form of hyperkeratosis caused by nitrosamines & hydrocarbons
Snuff pouch/ Smokeless tobacco keratosis
Mucosa granular to wrinkled, white it gray plaque
Snuff pouch
Most common area of involvement for snuff pouch
Mucobuccal fold of mand in incisor or molar region
High risk , precancerous condition, chronic progressive scarring of oral mucosa
OSMF
Associated with chwing of betel quid , paan & gutka
OSMF
Fibrosis of underlying submucosal tissue
OSMF
Induced fibroblasts proliferation, upregulated collagen shnthesis, downregulated collagenase production
OSMF
Blotchy, marblelike pallor and progressive stiffness
OSMF
Palpable fibrous bands running vertically on buccal mucosa
OSMF
Stiff mucosa, trismus
OSMF
Most affected sites for OSMF
Buccal mucosa, retromolar area, soft palate
Mild OSMF treatment
Intralesional corticosteroids
Moderate to severe OSMF tx
Surgical splitting or excision of fibrous bands
20% increased risk of development of squamous cell carcinoma
OSMF
Inflammatory reaction on oral mucosa caused by artificial cinnamon flavouring
Cinnamon contact stomatitis
For exposure affected mucosa becomes superficial white wrinkled appearance
Chemical burn
White plaque, unpleasant taste, burning sensation
Uremic stomatitis
Tx for uremic stomatitis
Mildly acidic mouth rinse, topical anesthetic
Common oppurtunistic oral mycotic infection
Candidiasis
Most common oral fungal infection
Candidiasis
Most common form of candidiasis
Pseudomembranous(thrush)
Adherent diffuse white mucosal plaque on cheek palate and tongue
Candidiasis
Plaque that can be wiped off leaving raw ulcerated and bleeding surface
Candidiasis
Type of candidiasis that can not be rubbed off
Chronic Hyperplastic candidiasis
Most common location for chronic hyperplastic candidiasis
Anterior buccal mucosa
Exfoliative cytology, hyphae
Candidiasis
Asymptomatic, multiple benign erythematous depapillated lesions surrounded by white borders on tongue
Geographic tongue
Marked accumulation of ketatin on filiform papillae on dorsal tongue, haur like appearance
Hairy tongue
Tx for hairy tongue
Remove etiological factors, keratolytic agents, brushing tongue
Yellowish white malodorous plaque like material, can not be scraped off
Saburral tongue
Ectopic sebaceous glands asymptomatic papules yellow white
Fordyce’s granules
Oral mucosal condition occurs more in blacks than whites
Leukoedema
Lesion disappears when mucosa stretched
Leukoedema
Increased thickening of epi and intra cellular edema of spinous layer
Leukoedema
Genetically inherited, asymptomatic, thick, white, corrugated, spongy, diffuse plaque on buccal mucosa bilterally
Wgite sponge nevus
Autoimmune multisystem disease
Lupus erythematous
Lesions disc shaped Atrophic with hyperkeratotic margins
Discoid lupus erythematous
Butterfly shaped erythematous rash/ malar rash
Systemic lupus erythematous
Kidney lesions glomerulobephritis & renal failure
Systemic lupus erythematous
Avoid sun exposure, UV light increases activity of this condition
Lupus erythematous
Hyperkeratotic white lesion related to chronic rubbing or friction
Frictional keratosis
Most common locations for frictional keratosis
Edentulous ridge, retromolar pad, buccal mucosa, lateral tongue & lips
Bilateral asymptomatic white lines along occlusal plane
Linea alba
Squamous papilloma caused by
HPV type 6 & 11
Soft, asymptomatic, pink to white exophytic nodule or cauliflower appearance with multiple finger like projections
Squamous papilloma
Asymptomatic papule or nodule with papillary projections or pebbly surface
Verruca Vulgaris (common wart)