white lesions Flashcards
features of epithelial thickening
asymptomatic, rough, DO NOT rub off
features of surface debris
symptomatic, rub off, underlying erythema
features of subepithelial lesions
asymptomatic, smooth to palpation, translucent
keratinized tissue in oral mucosa
tongue, hard palate, attached ging, outer lip
non-keratinized tissue in oral mucosa
everywhere else
buccal and labial mucosa, soft palate, floor of mouth
what makes lesions white
hyper-keratinized tissue
white sponge nevus
autosomal dominant with abnormal keratin production, appearing in early childhood
white sponge nevus presents as
multiple white rough surface lesions throughout oral cavity (bilateral)
vacuolation of the spinous layer appears in
white sponge nevus
tx for white sponge nevus
no tx needed, not pre malignant
frictional keratosis
huge callous
related to chronic rubbing or friction anywhere in the oral cavity (even on places that don’t normally have keratinized tissue)
tx of frictional keratosis
reduces/resolves after removal of causative agent
hairy tongue
elongation of filiform papillae due to the accumulation of keratin
tx of hairy tongue
brush/scrape with tongue
hairy leukoplakia
thickening of the BILATERAL surfaces of the tongue usually in immunocompromised pts
tx for hairy leukoplakia
none (other than to determine the immune status of the pt)
leukoedema
variation of normal that looks white, opalescent, filmy, folded surfaces, does not rub off
tx of leukoedema
none, stretch it goes away (water is “expelled” bt cells)
erythema migrans
geographic tongue/benign migratory glossitis
red with white borders due to atrophy of filiform papillae with elevated white border
opposite of hairy tongue
erythema migrans (destruction of filiform papillae due to inflammation)
type of sensation associated with erythema migrans
burning sensation
tx for erythema migrans
topical steroids for symptomatic lesions
lichen planus
common oversensitivity to T lymphocytes
AI disease with unknown trigger
how is lichenoid mucositis different than lichen planus
due to reaction to meds
graft vs host disease
may be focal or multifocal
but same microscopic and clinical appearance
skin features of lichen planus
p’s:
planar, purple, pruritic, polygonal, plaque, papule
describe the lesions of lichen plaus
multifocal, bilateral on buccal mucosa
2 types of presentations of lichen planus
- reticular (wickhams stria - white lacey)
2. erosive (painful ulceration, wickhams striae can be present too)
tx of reticular lichen planus
because they are asymptomatic, no tx occurs, but if there is burning, tx with topical corticosteroids
tx of erosive lichen planus
topical corticosteroids
clinical way to determine lichen planus or lichenoid mucositis
find out in the history if they have had a bone marrow transplant (graft vs host disease)
OR if it is unilateral reacting to amalgam
nicotinic stomatitis
hot nicotine causing inflammation of the palate/minor salivary gland ducts
no premalignant potential
t/f reverse smoker’s palate has a significant risk of dysplasia/carcinoma
true
linea alba
variation of normal, where the teeth come together on the buccal mucosa
no tx
morsicatio buccarum
chronic cheek chewing laborium = labial mucosa linguarum = tongue no tx (lateral acrylic shield
leukoplakia
a white patch/plaque that cannot be characterized clinically as any other disease
only way to determine true diagnosis is with a biopsy and microscope
t/f. leukoplakia is strictly a clinical term and implies a specific diagnosis
true, then false. it does NOT imply a specific diagnosis
hyperkeratosis
callous, not premalignant, does not need removal
epithelial dysplasia
premalignant
mild - not removed; moderate - can be removed; severe - remove
t/f carcinoma in situ and superficial squamous cell carcinoma must be removed
true
t/f. carcinoma in situ is confined to epithelium
true
candida
most common oral fungal infection
component of normal oral microflora
predisposing factors to candida
immunodeficiency, acquired immunosupression, endocrine disturbances, DM, corticosteroids, systemic sb therapy, xerostomia, bad hygiene
pseudomembrane candidosis
thrush
white plaques that RUB OFF leaving a red base
pain or burning sensation
tx of candidiasis
topical - nystatin rinse or ointment, clotrimazole rinse or troches, ketoconazole cream
systemic - ketoconazole or fluconazole tablets
what can determine diagnosis of candida
cytology smear
toothpaste slough is due to
sodium lauryl sulfate and pyrophosphates which can cause burning and look like gray/white plaques, but is more apparent in the morning
burns are an area of…
yellow-white epithelial necrosis
congenital cysts
developmental “inclusion” cysts
Epstein pearls or Bohns nodules (salivary) or gingival cysts of a new born
tx of cysts
no tx
fordyce granules
ectopic sebaceous (sweat) glands that appear as yellow, granular plaques and nodules
tx of fordyce granules
none
if something is classified as leukoplakia, it can be 1 of these 4 things
hyperkeratosis (most frequent)
epithelial dysplasia
carcinoma in situ
squamous cell carcinoma
