White lesions

Question 1

What are the different kinds of white lesions

Answer 1

developmental
normal variation
hereditary
traumatic
dermatological
infective
idiopathic
neoplastic

Question 2

example of developmental white lesion

Answer 2

fordyce granules

Question 3

example of normal variation white lesion

Answer 3

leukodema

Question 4

example of hereditary white spot lesion

Answer 4

white sponge naevus

Question 5

types of traumatic white spot lesion

Answer 5

mechanical/frictional
chemical
thermal

Question 6

example of dermatological white spot lesion

Answer 6

lichen planus

Question 7

Example of infective white spot lesion

Answer 7

candidiosis
syphillitic leukoplakia
oral hairy leukoplakia

Question 8

example of idiopathic white spot lesion

Answer 8

leukoplakia

Question 9

example of neoplastic white spot lesion

Answer 9

squamous cell carcinoma

Question 10

features of white sponge naevus

Answer 10

• autosomal dominant
• may be apparent in infants or not until adolescence
• ill-defined white patches with ‘shaggy’ surface
• often bilateral
• any part of oral mucosa esp buccal mucosa
• can also affect nose, oesophagus, anogenital region
• mutations in keratins 4/13

Question 11

Histopathological appearance of white sponge naevus

Answer 11

basket weave appearance

Question 12

Treatment for white sponge naevus

Answer 12

none required

Question 13

Oral hairy leukoplakia clinical features

Answer 13

• white shaggy appearance on lateral tongue
• asymptomatic
• can affect other sites
• due to EBV infection
• strongly associated with HIV infection
• also seen in immunosuppressed individuals and in some healthy patients

Question 14

Histopathology of oral hairy leukoplakia

Answer 14

• thickened hyper parakeratotitic epithelium
• ballooned pale cells in upper prickle cell layer

Question 15

Treatment for oral hairy leukoplakia

Answer 15

none required

Question 16

what is lichen planus

Answer 16

common chronic inflammatory disease of skin and mucous membranes

Question 17

Aetiology of lichen planus

Answer 17

unknown

Question 18

clinical features of lichen planus

Answer 18

• characteristic skin lesion is a violaceous, itchy papule which may have distinctive white streaks of the surface
• flexor surface of the wrist is the most common site
• buccal mucosa most common oral site
• oral lesions usually bilateral and often symmetrical

Question 19

spectrum of appearances of lichen planus

Answer 19

reticular
atrophic
plaque like
papular
erosive
bullous

Question 20

histopathology of lichen planus

Answer 20

• hyperorthokeratosis/ hyperparakeratosis of epithelium which may be acanthotic or atrophic
• saw tooth rate ridges

Question 21

Treatment of lichen planus

Answer 21

symptomatic - options include steroids

Question 22

is lichen planus an oral potentially malignant disorder

Answer 22

YES
lichen planus is an oral potentially malignant disorder

Question 23

what is leukoplakia

Answer 23

white plaque of questionable risk

Question 24

risk of malignant transformation of leukoplakia

Answer 24

low

Question 25

what is proliferative verrucous leukoplakia

Answer 25

clinics-pathological variant of oral leukoplakia that is multifocal, persistent and progressive with a high rate of recurrence and high risk of progression to squamous cell carcinoma

Question 26

proliferative verrucous leukoplakia clinical features

Answer 26

• older patients
• gingival, alveolar ridge, buccal mucosa, tongue, hard palate
• persistent, recurrent and becomes multifocal
• aetiology unknown
• difficult to completely excise
• high risk it may degenerate into oral cancer