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Oral Pathology 1 > White Lesions (new) > Flashcards

White Lesions (new) Flashcards

1
Q

White Surface Lesions

Epithelial Thickening

A

Asymptomatic

Rough

DO NOT rub off

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2
Q

12 White Lesion Epi Thickening

A
  • White SPonge Nevus
  • Frictional Keratosis
  • Hairy Tongue
  • Hairy Leukoplakia
  • Lichen Planus
  • Leukoedema
  • Geographic Tongue
  • Lichenoid Reaction
  • Nicotinic Stomatitis
  • Smokeless Tobacco Keratosis
  • Linea Alba/ Morsicatio
  • Leukoplakia
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3
Q

White Sponge Nevus Apperance

A
  • Multiple white rough surface lesions through out oral cavity
  • Symmetrical
  • Thickened
  • Corrugated/velvety
  • Diffuse plaques
  • Bilateral on buccal mucosa
  • Also on ventral tongue, labial/alveolar mucosa, soft palate, floor of mouth
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4
Q

White SPonge Nevus

Cause

Tx

A
  • Autosomal dominant inheritance
  • Mutation of keratin gene, abnormal production
  • May involve anal and genital
  • Other family memeber may have
  • Appears in early childhood
  • Not premalignant
  • No tx needed
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5
Q

Frictional Keratosis

Apperance

Cause

Treat

A
  • White due to chronic rubbing/friction
  • Anywhere in oral cavity
  • Should resolve after removal of causative agent
  • Otherwise no tx needed
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6
Q

Hairy Tongue

Apperance

Cause

Treat

A
  • Elongation of filiform papilae due to accumulation of keratin on the dorsumof tongue
  • Associated with lack of abrasion of tongue
  • Treat; brush or scrape
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7
Q

Hairy Leukoplakia

Apperance

Cause

Treat

A
  • Epithelial thickening of the lateral surfaces of the tongue
  • Thickened parakeratin
  • Surface corrugations
  • Acanthotic epithelium
  • Present in immunocompromised patients HIV, transplant
  • Treat: None
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8
Q

Leukoedema

Apperance

Distribution

Cause

Diagnosing

Treat

A
  • Apperance
    • White, opalescent, filmy, folded surface, not rough
  • Distribution
    • bilateral buccal mucosa
  • Cause
    • common, asymptomatic, more easily recognized in African Americans
  • Diagnose
    • white apperance decreases when stretched
  • No treatment needed
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9
Q

Erythema Migrans

Distribution

Apperance

Due to

Treat

A
  • Commonly seen on ant 2/3 tongue and ventral and lateral surfaces
  • Apperance
    • Red patches with white border
    • multiple well-demarcated, irregular, sharply defined tortous, yellow-white border
  • Due to atrophy of filiform papillae with elevated white border
  • Treat
    • not needed, topical steroids for symptomatic lesions
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10
Q

Lichen Planus

Cause

Distribution

A
  • Common dermatoligical disease
  • Oversensitivity reaction of T lymphocytes
  • Lesions are multifocal
  • Typically bilaterally buccal mucosa
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11
Q

Lichen Planus: Reticular Pattern

Apperance

Treat

A
  • Wickhams Striae
    • white lacy network with underlying erythema
    • Wax and wane over weeks and months
  • Asymptomatic no treatment needed
  • If burning then topical corticosteroids
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12
Q

Lichen Planus: Errosive Pattern

Apperance

Treat

A
  • Central area of ulceration painful
  • Psudomembrane with erythema and possible Wickhams
  • May present as desquamative gingivitis
  • Treat
    • topical corticosteroids
    • Flareups require reapplicatoin or prophylatic treatment
    • Severe cases- Systemic Corticoid therapy
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13
Q

Lichenoid Mucositis

Causes

Dist

A
  • Clinical and micro findings similar to lichen planus
  • Causes:
    • Rxn to flavoring agents (cinammon mint)
    • Rxn to medication
    • Graft vs Host disease
  • May be focal or multifocal
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14
Q

Nicotinic Stomatitis

A
  • Hard palate of smokers
  • No treatment
  • Almost no potential for transformation to squamous cell carcinoma
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15
Q

Line Alba

Cause

Distribution

Treat

A
  • Common alteration of buccal mucosa
  • Pressure, frictional irritation or sucking trauma from the facial surfaces of the teeth
  • Usually bilateral
  • No treatment
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16
Q

Morsicatio Buccarum

Cause

Distribution

Apperance

Treat

A
  • Chronic check chewing
    • Labial mucosa= Morsicatio labiorum
    • Tongue= Morsicatio linguarum
  • Usually bilateral
  • Thickened, shredded, areas of white hyperkeratosis
  • No treat needed
17
Q

Leukoplakia Definition

A
  • White patch or plaque that cannot be characterized clinically or pathologically as any other disease
  • Strictly a clinical term and does not imply diagnosis
  • Dependent on the exclusion of other white lesions
18
Q

Lesions that must be excluded before the term Leukoplakia can be used 9

A
  • White sponge nevus
  • Frictional Keratosis
  • Hairy tongue or lukoplakia
  • Leukoedema
  • Geo tongue
  • Lichen Planus/Lichenoid Mucositis
  • Tobacco pouch hyperkeratosis
  • Nicotine stomatits
  • Morsicatio (chronic chewing on tissue)
19
Q

Leukoplakia must be microscopically diagnosed by biopsy and will be one of the following

A
  • Hyperkeratosis
  • Epithelial dysplasia
  • Epithelial dysplasia
  • Carcinoma-in-situ
  • Superficial squamous cell carcinoma
20
Q

Hyperkeratosis

A
  • Callous
  • Not premalignant
  • Does not need removal
21
Q

Epithelial Dysplasia

A
  • Atypical cells confined to the cells of the epithelium
  • Considered premalignant
    • mild dysplasi not removed
    • Moderate may be removed
    • Severe must be removed
22
Q

Carcinoma In-situ

A
  • cancer confined to the epithelium
  • Will eventually invade
  • MUST be removed
23
Q

Superficial Squamous Cell Carcinoma

Treat

A

MUST be removed

24
Q

White Surface Debris Lesions

A
  • Symptomatic
  • Rub off
  • Underlying erythema
  • Include
    • Candidosis
    • Burn
    • Dentrifice-associated slough
25
Q

Candidosis

Predisposing factors

A
  • Caused by Candida albicans
  • Predisposing factors
    • Immunodeficiency
    • Acquired immunosuppresion
    • Endocrine disturbances
    • Diabetes mellitus
    • Corticosteroid therapy
    • Systemic antibiotic therapy
    • Xerostomia
    • Poor oral hygeine
26
Q

Pseudomembranous Candidosis Thrush

App

Symptoms

Assoc with

A
  • White plaques that rub off leaving an erythematous base
  • Pain or burning sensation
  • Assoc with xerostomia, AB, decreased host resistance
27
Q

Erythematous Candidosis

A
  • RED variations
    • Acute Erythematous candidosis
    • Chronic
    • Angular Chelitis
    • Median Rhomboid Glossitis
28
Q

Management of Candidosis

A
  • Cytology smear to confirm
  • Antifungal medications
    • Topical or systemic
29
Q

Dentrifice-Associated Slough

Apperance

Associated with

A
  • Painless, grayinsh-white gelatinous membranes on gingiva, vestibule, floor of mouth, lips
  • Most apparent in morning
  • Associated with sodium lauryl sulfate and pyrophosphates
  • May cause burning
  • Switch toothpaste
30
Q

Chemical Injury Apperance

A

Mucosa develops white, wrinkled apperance.

Removal of necrotic epithelium reveals red, bleeding tissue

31
Q

Burn apperance

A

Area of yellow-white epithelial necrosis

32
Q

Subepithelial White Lesions general

A

Asymptomatic Smooth to palpation translucent

33
Q

Subepithelial White Lesions 5

A
  • Congenital cysts
    • Palatal cysts of newborn
      • Bohns nodules
      • Epsteins pearls
    • Gingival cysts of newborn
  • Subepithelial fibrosis (scar)
  • Fordyce Granules
34
Q

Palatal Cysts

2 kinds Cause

A
  • Small developmental inclusion cysts
  • Epsteins pearls
    • Palatal shelves fusing at midline entrap small islands of epithelium
  • Bohns nodules
    • Epithelial remnants from minor salivary glands on palate entrapped
35
Q

Gingival Cysts of newborn

A
  • Entrapment of dental lamina
  • Apperance similar to palatal variant
  • Resolve spontaneously
36
Q

Subepithelial Fibrosis (scar)

A
  • Usually poorly defined
  • Hx on inkury
  • No tx needed
37
Q

Fordyce Granules

A
  • Represent ectopic sebaceous glands
  • Yellow, granular plaques and nodules present in clusters
  • Commonly on buccal mucosa and lip
  • Diagnosis based on clinical basis
  • No tx needed

Oral Pathology 1 (12 decks)

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