White Lesions: Nonepithelial White-Yellow Lesions Flashcards
Nonepithelial White-Yellow Lesions
a. Candidiasis
b. Mucosal Burns
c. Submucous Fibrosis
d. Fordyce’s Granules
e. Ectopic Lymphoid Tissue
f. Gingival cyst
g. Parulis
h. Lipoma
Thrush, angular cheilitis, median rhomboid glossitis, denture sore
mouth, yeast infection, candidal leukoplakia, antibiotic stomatitis, moniliasis
Candidiasis
a commensal organism residing in the oral cavity in a majority of healthy persons.
Transformation, or escape from a state of commensalism to
that of a pathogen, relates to local and systemic factors
C. albicans
necessity for local or systemic predisposing factors to
produce a disease state
Candidiasis
Immunodeficiency
Immunologic immaturity of infancy
Acquired immunosuppression
Endocrine disturbances
Diabetes mellitus
Hypoparathyroidism
Pregnancy
Hypoadrenalism
Corticosteroid therapy, topical or systemic
Systemic antibiotic therapy
Malignancies and their therapies
Xerostomia
Poor oral hygiene
Candidiasis: Predisposing Factors
The most common clinical type of is the acute pseudomembranous form, also known as thrush
Candidiasis
Wiping away the plaques or pseudomembranes with a gauze sponge leaves a painful erythematous, eroded, or ulcerated surface
Candidiasis
Nystatin, Clotrimazole, Fluconazole, ketoconazole
Candidiasis treatment
- This is characterized by soft white plaque that may grow separately or merge.
- The lesions are mildly painful, fissured, eroded and encrusted
Candidiasis
most common form is associated with topical applications of chemicals (aspirin or caustic agents), topical abuse of drugs, use of alcohol containing mouth rinses.
Mucosal Burns
- Localized mild erythema
- Thickened white slough and extends deep in the connective tissue with time
Mucosal Burns
the epithelial component
shows coagulative necrosis through its entire thickness. A
fibrinous exudate is also evident. The underlying connective tissue is intensely inflamed.
Mucosal Burns
mucosal burns may be thermal, chemical and electrical burns.
which is more destructive, showing deep extension of necrosis, often into
muscle?
electrical burn
Sodium bicarbonate mouth rinse with
analgesics and Surgical treatment for electric burns
Mucosal Burns treatment
primary factor appears to be chewing of the areca (betel) nut
contributory factors are: general nutritional or vitamin deficiencies and hypersensitivity to various dietary constituents
Submucous Fibrosis
the principal feature is atrophy of the epithelium and subjacent fibrosis
Submucous Fibrosis
due to impaired degradation of normal collagen by fibroblasts rather than excess production
Submucous Fibrosis
- presents as a whitish yellow change that has a chronic, insidious biological course
- Fibrous bands are readily palpable in the soft palate and the buccal mucosa
- The clinical result is significant trismus with considerable difficulty in eating
Submucous Fibrosis
- Eliminating causative agents
- Therapeutic measures include:
- Local injections of chymotrypsin
- Hyaluronidase
- Dexamethasone, with surgical excision of fibrous bands and submucosal placement of vascularized free flap grafts
Submucous Fibrosis
ectopic sebaceous glands or sebaceous choristomas (normal tissue in an abnormal location).
This condition is regarded as developmental and can be considered a variation of normal.
Fordyce’s Granules
Microscopically, lobules of sebaceous glands are aggregated around or adjacent to excretory ducts
Symmetrically distributed and tend to become obvious after puberty
Asymptomatic
Fordyce’s Granules
may be found in numerous oral locations,
most notably in the region surrounding the oropharynx termed Waldeyer’s ring
Ectopic Lymphoid Tissue
Lymphoid tissue appears yellow or yellow-white clinically and typically produces small, dome-shaped elevations.
The tissue appears uninflamed, and the patient is unaware
of its presence.
Ectopic Lymphoid Tissue
Crypts in the lymphoid tissue occasionally
may become obstructed, causing “cystic” dilation of the area.
These lesions may be called lymphoepithelial cysts.
Ectopic Lymphoid Tissue
Because this is basically normal tissue, no biopsy may be needed
Ectopic Lymphoid Tissue
Gingival cysts in infants
Bohn’s nodules
- presents as a painless growth in the attached gingiva, often within the interdental papilla
gingival cyst
- Only rarely are lesions found in the lingual gingiva. Premolar and bicuspid regions of the mandible are favored locations
gingival cyst
probably formed from remnants of the dental lamina (with keratin) within the gingival submucosa.
gingival cyst
- No treatment is indicated for the newborn because they spontaneously rupture early in life
- Treatment for the adult is surgical excision
gingival cyst
Gum Boil
Parulis
- Represents a focus of pus in the gingiva
- The lesion appears as a yellow-white gingival tumescence with an associated erythema
- Pain is typical, but once the pus escapes to the surface, symptoms are temporarily relieved
Parulis
appears as a yellow or yellow-white uninflamed submucosal mass of adipose tissue
Lipoma
Lump of fatty tissue that grows just under the skin.
move easily when you touch them and feel rubbery, not hard.
Most aren’t painful and don’t cause health problems so they rarely need treatment.
Lipoma
