Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Oral Path 1 > White Lesions > Flashcards

White Lesions Flashcards

1
Q

White surface lesions are divided into 3 groups based on their clinical features:

A
  • Epithelial thickening
    • Asymptomatic, rough, do not rub off
  • Surface debris
    • Symptomatic, rub off, underlying erythema
  • Subepithelial lesions
    • Asymptomatic, smooth palpation, translucent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Keratinized tissues

A
  • Tongue
  • Hard palate
  • Attached gingiva
  • Outer lip (past vermillion border)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-keratinized tissues

A
  • Everywhere else that isn’t the tongue, hard palate, attached gingiva, or outer lip (past vermillion border)
  • Buccal mucosa
  • Labial mucosa
  • Soft palate
  • Floor of the mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What gives white lesions their color?

A

Excessive keratin build up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

White Sponge Nevus

A

Familial Epithelial Hyperplasia

  • Autosomal Dominant inheritance
  • Mutation of keratin genes
    • Abnormal keratin production
  • Presents as multiple white rough surface lesions throughout the oral cavity
  • May involve anal and genital mucosa
  • Appears in early childhood
  • Not malignant
  • Tx: None
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Frictional Keratosis

A
  • Related to chronic rubbing or friction
  • Anywhere in the oral cavity
  • Careful history taking and examination sufficient for dx
  • Tx: Lesion should resolve or reduce after removal of causative agent. Otherwise, no tx needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hairy Tongue

A
  • Represents elongation of filiform papillae due to accumulation of keratin on the dorsum of the tongue
  • Associated with lack of mechanical abrasion to tongue
  • Tx: Brush/scrape tongue
  • Px: Good
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hairy Leukoplakia

A
  • Epithelial thickening of the lateral surfaces of the tongue
  • Present in immunocompromised patients i.e. HIV, AIDS, transplant patients, etc
  • Tx: None, other than to determine the immune status of the patient
  • Px: Indicates poorly functioning immune system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lichen Planus

A
  • Common dermatologic disease that often affect oral mucosa
  • Oversensitivity rxn of T lymphocytes
  • Most patients are middle-aged adults; 3:2 F:M
  • Skin features sometimes present:
    • Planar
    • Purple
    • Pruritic
    • Polygonal
    • Plaque
    • Papule
  • Oral features
    • Lesions are multifocal; typically bilateral on the buccal mucosa
      • Reticular Pattern
      • Erosive Pattern
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lichen Planus: Reticular Pattern

A
  • Wickham’s Striae: white lacy pattern with underlying erythema
  • White plaques sometimes present
    • Asymptomatic and are not tx’d
  • More common form
  • Multifocal lesions; usually bilateral
  • Wax and wane over wks/mos
  • Tx: If burning, rx topical corticosteroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lichen Planus: Erosive Pattern

A
  • Central area of ulceration that is painful
  • Areas of pseudomembrane centrally may be present
  • Multifocal; usually bilateral
  • Wickham’s striae may be present
  • Less common, but more significant and painful
  • Central erosion/pseudomembrane w/ erythema and possibly Wickham’s striae
  • May present as desquamative gingivitis
  • Tx: Topical corticosteroids. Flare-ups require reapplication of drugs or prophy tx. Severe cases rx systemic corticoid tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Leukoedema

A
  • Common, asymptomatic, variation of normal
  • White, opalescent, filmy, folded surface, does not rub off, rough
  • Distribution: bilateral buccal mucosa
  • More common in AA vs. more easily recognized in AA population
  • Dx clinically: white appearance decreases when tissue is stretched
  • Tx: None
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Erythema Migrans

A
  • AKA geographic tongue, benign migratory glossitis
  • Commonly seen on anterior 2/3 of tongue and ventral and lateral surfaces
  • Red patches with white border
  • Due to atrophy of filiform papillae w/ elevated white border
  • Presents as multiple, well-demarcated, irregular red patches with sharply defined, tortuous, yellow-white border
  • Lesions resolve in some areas and appear in other areas = migratory
  • Usually asymptomatic
  • Can be associated with burning sensation
  • Cause is unknown
  • Tx: None. Topical steroids for symptomatic lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lichenoid Mucositis/Rxn

A
  • Looks like lichen planus bc of inflammation in the mucosa
    • Clinical and microscopic findings are similar
  • Causes
    • Rxn to flavoring agents (cinnamon, mint, etc)
    • Rxn to medicine
    • Graft vs. Host Disease
      • Immune system is attacking the host
    • Can be focal or multifocal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nicotinic Stomatitis

A
  • Present on hard palate of smokers - mainly pipe or cigar
  • Almost no potential (on hard palate) for transformation to squamous cell carcinoma
    • Response to heat rather than chemicals
  • Tx: None needed
  • Reverse Smoker’s Palate = pronounced nicotinic stomatitis
    • Significant risk of dysplasia or carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Linea Alba

A
  • Common alteration of buccal mucosa
  • Pressure, frictional irritation, sucking trauma from facial surfaces of the teeth
  • Usually bilateral
  • Tx: N/A
17
Q

Morsicatio Buccarum

A
  • Chronic cheek chewing
    • Labial mucosa = morsicatio labiorum
    • Tongue = morsicatio linguarum
  • Usually bilateral
  • Tx: N/A
    • Lateral acrylic shields connected by steel wire
18
Q

Leukoplakia

A
  • Strictly a clinical term and is NOT a dx. Cannot be characterized clinically or pathologically as any other disease
  • You must be able to exclude all the above white lesion conditions before using “leukoplakia”
  • Typically considered precancerous or premalignant because of the frequency of the leukoplakia to become malignant is greater than the risk associated with normal mucosa
  • Most leukoplakias are hyperkeratosis w/o dysplasia or cancer
  • Definitive dx by microscopic dx of a biopsy may show one of the following:
    • Hyperkeratosis: Callous
      • Not pre-malignant; does not need to be removed
    • Epithelial dysplasia: Atypical cells confined to the cells of the epithelium
      • Enlarged nuclei/cells
      • Increased nuclear-to-cytoplasmic ratio
      • Hyperchromatic nuclei
      • Pleomorphic cells
      • Increased/abnormal mitotic activity
    • Pre-malignant
      • Mild = usually not removed
      • Moderate = may be removed
      • Severe = must be removed
    • Carcinoma-in-situ: Cancer confined to the epithelium
      • Will eventually invade
      • Must be removed
    • Superficial squamous cell carcinoma
      • Must be removed
19
Q

Two types of candidosis

A
  • Oral thrush - pseudomembranous candidosis
  • Erythematous candidosis
20
Q

Oral thrush - Pseudomembranous Candidosis

A
  • White plaques rub off, leaving an erythematous base
  • Best recognized form
  • Pain or burning sensation
  • Often associated w/ xerostomia, abx, and/or decreased host resistance
  • Common opportunistic oral mycotic infection
    • Most common oral fungal infection in humans
  • Component of normal oral microflora
  • Predisposing factors
    • Immunodeficiency; acquired immunosuppression; endocrine disturbances; diabetes mellitus; corticosteroid tx; systemic abx tx; xerostomia; poor OH
21
Q

Erythematous Candidosis

A
  • More common than white
  • Red variations
    • Acute erythematous candidosis
    • Chronic erythematous candidosis
    • Angular chelitis
    • Median rhomboid glossitis
  • Tx: Cytology smear confirms dx
    • Topical (nystatin, clotrimazole) and systemic (ketoconazole, fluconazole) antifungal meds
22
Q

Burn

A
  • Heat, cold, chemicals
  • Area of yellow-white epithelial necrosis
  • Supporting hx
23
Q

Chemical Injury

A
  • Chemicals/drugs in prolonged contact w/ oral tissues
  • Pain in area of application
  • Children/psychiatric pts may hold meds in their mouth
  • Topicals for pain can compound the problem
24
Q

Dentrifice-Associated Slough

A
  • Painless, gray-white gelatinous membranes on gingiva, vestibule, floor of mouth and lips
    • Most obvious in the morning
    • Associated w/ SLS and pyrophosphates found in some dentrifices and mouth rinses
    • May cause burning sensation
25
Q

Subepithelial lesions - Congenital Cysts

A
  • Palatal cysts
  • Gingival cysts
26
Q

What are the two types of congenital palatal cysts?

A
  • Bohn’s Nodules: Epithelial remnants from minor salivary glands of palate entrapped below the surface
  • Epstein’s Pearls: Palatal shelves fusing at the midline entrap small islands of epithelium
27
Q

Subepithelial gingival cysts

A
  • Entrapment of dental lamina
  • Appearance similar to palatal variant
  • Dental lamina cyst & congenital keratotic cyst
28
Q

Subepithelial Fibrosis (Scar)

A
  • Usually poorly defined
  • H/o injury or surgery
  • Tx: N/A
29
Q

Fordyce Granules

A
  • Represent ectopic sebaceous glands
  • Yellow-granular plaques and nodules present in clusters
  • Most commonly located on the buccal mucosa & lip
  • Dx based on clinical basis
  • Tx: N/A

Oral Path 1 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions