White lesions Flashcards
What are the different kinds of white lesions
developmental
normal variation
hereditary
traumatic
dermatological
infective
idiopathic
neoplastic
example of developmental white lesion
fordyce granules
example of normal variation white lesion
leukodema
example of hereditary white spot lesion
white sponge naevus
types of traumatic white spot lesion
mechanical/frictional
chemical
thermal
example of dermatological white spot lesion
lichen planus
Example of infective white spot lesion
candidiosis
syphillitic leukoplakia
oral hairy leukoplakia
example of idiopathic white spot lesion
leukoplakia
example of neoplastic white spot lesion
squamous cell carcinoma
features of white sponge naevus
- 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
Histopathological appearance of white sponge naevus
basket weave appearance
Treatment for white sponge naevus
none required
Oral hairy leukoplakia clinical features
- 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
Histopathology of oral hairy leukoplakia
- thickened hyper parakeratotitic epithelium
- ballooned pale cells in upper prickle cell layer
Treatment for oral hairy leukoplakia
none required
what is lichen planus
common chronic inflammatory disease of skin and mucous membranes
Aetiology of lichen planus
unknown
clinical features of lichen planus
- 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
spectrum of appearances of lichen planus
reticular
atrophic
plaque like
papular
erosive
bullous
histopathology of lichen planus
- hyperorthokeratosis/ hyperparakeratosis of epithelium which may be acanthotic or atrophic
- saw tooth rate ridges
Treatment of lichen planus
symptomatic - options include steroids
is lichen planus an oral potentially malignant disorder
YES
lichen planus is an oral potentially malignant disorder
what is leukoplakia
white plaque of questionable risk
risk of malignant transformation of leukoplakia
low
what is proliferative verrucous leukoplakia
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
proliferative verrucous leukoplakia clinical features
- 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