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Oral Medicine > White Lesions > Flashcards

White Lesions Flashcards

1
Q

White Sponge Nevus

  • General aspects
A

General:

  • hereditary autosomal dominant
  • appears in childhood, progresses till 2nd decade and becomes stable and persists entire life
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2
Q

White Sponge Nevus

  • Clinical
  • Oral
A

Clinically and orally:

  • only on mucosa (mostly jugal m.)
  • side of the tongue I
  • labial mucosa
  • floor & alv. mucosa
  • corrugated
  • spongy
  • symmetrical
  • size varies depending on one period of time to another
  • asymptomatic, painless
  • Does not disappear when m. retracted
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3
Q

White Sponge Nevus

  • Diagnosis
  • Differential Diagnosis
A

Diagnosis:

  • anamnesis
  • clinical data
  • histo-exam (if px insists)
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4
Q

White Sponge Nevus

  • Treatment
A

Treatment:

  • Not needed, because:
    - asymptomatic
    - painless
    - benign
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5
Q

Traumatic Keratosis
(Frictional Hyperplasia)

  • General
A

General:
It’s a projective tissue reaction at the prolonged action of minor traumatic factors

  • Thickened white lesion w/local rash
  • like the name says caused by local frictional forces
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6
Q

Traumatic Keratosis
(Frictional Hyperplasia)

  • Clinical
  • Diagnosis
A

Clinical:

  • on jugal mucosa occlusal Pläne of teeth
  • lips
  • side of tongue
    Cause: 1) root rests
    2) orthodontic applications
    3) sharp edges
    4) aggressive lip/cheek biting
    5) using edent. ridge for mastication

Diagnosis: clinical exam

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7
Q

Traumatic Keratosis
(Frictional Hyperplasia)

  • Treatment
A

Treatment:

Remove etiological agent
+
follow up

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8
Q

Nicotinic Stomatitis

  • General
A

General:

  • Reactive lesion caused by prolonged irritation of heat and chemicals resulted from tobacco burning
  • mostly in middle aged men, heavy smokers
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9
Q

Nicotinic Stomatitis

  • Clinical
A

Clinical: 3 stages

1) diffused erythema
2) hyperkeratinized epithelium
3) thicker white-grayish mucosa

  • opening of salivary ducts dilate, inflame & Show red small dots (1-5mm)
  • ONLY on hard palate
  • chronic case: - fissures
    - pavement aspect
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10
Q

Nicotinic Stomatitis

  • Histopathology
A

Histopathology:

  • thickened epithelium: ^^orthokeratin layer
  • moderate acanthosis
  • cellular atypia
  • salivary ducts: squamous metaplasia and inflammation
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11
Q

Nicotinic Stomatitis

  • Treatment
A

Treatment:

  • Quit smoking!
  • heals in a long period of time
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12
Q

Solar Cheleitis
(Actinic Chelitis)

  • General
A

General:

  • caused by prolonged exposure to solar radiations
  • affects ONLY lower lip
  • mostly in white men >40 y.o. spending long time outside (farmer, constructor)
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13
Q

Solar Cheleitis

  • Clinical
A

Acute: : Mild keratosis

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14
Q

Solar Cheleitis

  • Diagnosis
  • Differential Diagnosis
A

Diagnosis:

  • Histopathological exam
  • Toluidine blue staining + Biopsy
    (Because cancerous lesion)

Differential Diagnosis:

  • Exfoliative chelitis (lip biting)
  • Allergic chelitis
  • Lupus erythema
  • Carcinoma
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15
Q

Solar Cheleitis

  • Treatment
A

Preventive Treatment:

  • avoid sun
  • apply para-amino-benzoic-acid
  • Zink oxide and Titanium dioxide
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16
Q

Idiopathic Leukoplakia

  • General
A

Any white stain/ plaque on oral m. that can NOT be removed, by wiping & is not classified into other disease

  • it’s a thickening of mucosa through huperkeratinization w/ cancerous potential
17
Q

Idiopathic Leukoplakia

  • Etiology
A

mainly UNKNOWN

Could be:

Tobacco

18
Q

Idiopathic Leukoplakia

  • Appearance
A 
Location: 
- buccal mucosa
-tongue 
- palate
- Lips
- floor of the mouth 
Size: varies from 0,5 to all oral cavity
Colour: translucent white, white yellow to grey
Surface: neat & homogenous 
               Thin & friable 
                Nodular or Stained
                Verrucous
19
Q

Idiopathic Leukoplakia

  • Forms
A 
Homogenous 
        &
Non-homogenous:
1. Erythroleukoplakia (red in middle)
2. Nodular leukoplakia (Raspberry like)
3. Verrucous leukoplakia (cowliflower like Tumor)
20
Q

Idiopathic Leukoplakia

  • Histopathology
A
  • varied forms of hyperorthokeratosis
  • hyperkeratosis
  • acanthosis
  • mild/medium/high epithelial Dysplasia
  • 5% can be invasive carcinomas w/squamous cells
21
Q

Idiopathic Leukoplakia

  • Clinical
A

non-homogenous:
- 60% present Candida albicans
- 50% present epithelial Dysplasia
&raquo_space; malignant transformation

All lesions:
-4-6% has cancerous tendency

  • asymptomatic
  • burning sensation when irritant comes in contact with lesions presenting cracks ulcerations, erosions
22
Q

Idiopathic Leukoplakia

  • Differential Diagnosis
A
  • All keratotic lesions
  • lichen planus
  • leukoedema
  • white Sponge Nevus
  • chronic hyperplastic candidiasis
23
Q

Idiopathic Leukoplakia

  • Treatment
A

1) remove irritating factors
2) antifungal therapy 1-2w+ re-evaluation
3) Biopsy (excision)
In case of Dysplastic absence:
-local or systemic adm. of retinoid &

24
Q

Hairy Leukoplakia

  • General
  • Etiology
A

Is a white patch on the side of the tongue in immonucompromised patients eg. HIV patients caused by the Epstein Barr virus

25
Q

Hairy Leukoplakia

  • Clinical aspects and symptoms
A

Located almost exclusively on the side of the tongue

26
Q

Hairy Leukoplakia

  • Histopathology
A

Acanthosis and Hyperkeratinization

27
Q

Hairy Leukoplakia

  • Diagnosis
  • Differential Diagnosis
A

Diagnosis:
Anamnesis and Clinical exam

Differential Diagnosis:

  • idiopathic leukoplakia
  • candidiasis
  • Frictional keratosis
  • hypertrophic lichen planus
28
Q

Hairy Leukoplakia

  • Treatment
A

Treatment: is non-specific and
Note that the lesion reappears after treatment is stopped

1) pedophyllin -topical (antiviral/keratolytic)
2) Tretinoin gel/sol. Retin-A + Acyclovir
3) Antiretroviral meds AZT (HIV treatment)
Zidovudine

29
Q

Hairy Tongue

  • General
  • Etiology
A

Hairy tongue is when a buildup of filiform papillae forms on the tongue, creating a layer of “hair”.
HYPERTROPHY & Elongation of filiform papillae on the dorsal side of tongue.
In adults it is also called black tongue.
The Etiology is unknown

30
Q

Hairy Tongue

  • predisposing factors
A
  • Long Time use of antibiotics
  • systemic corticosteroid therapy
  • oxidant mouthwash agents
  • salivary pH modification
  • intense smoking
  • poor oral hygiene
  • Candida albicans infection
31
Q

Hairy Tongue

  • Diagnosis
A

Clinical Data + view

32
Q

Hairy Tongue

  • Treatment
A

1) scraping w/wooden spatula
2) mouthwash(hydrogen peroxide & Zink oxide
3)

33
Q

Geographic tongue

  • General
  • Etiology
A
  • Benign inflammatory condition caused by dekeratinization and desquamation of filiform papillae
  • Etiology unknown; predisposing factors: emotional stress, nutritional def., hereditary
  • 2% teenagers and young adults, mostly women and teenager

Oral Medicine (1 decks)

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