White Lesions: Other White Lesions Flashcards
Other White Lesions
a. Geographic Tongue
b. Lichen Planus
c. Lupus Erythematosus
also known as erythema migrans and benign migratory glossitis
Geographic Tongue
more prevalent in the young, in nonsmokers, and in allergic or atopic individuals
Geographic Tongue
Appears as red atrophic patches surrounded by hyperkeratotic (white) margins
Dorsum and lateral surfaces of tongue usually affected; rarely other mucosal sites
Geographic Tongue
strongly associated with fissured tongue, but it is inversely associated with cigarette smoking.
Geographic Tongue
associated, coincidentally, with several different conditions, including
psoriasis, seborrheic dermatitis, Reiter’s syndrome, and atopy
Geographic Tongue
Pattern changes with time (migratory glossitis)
Spontaneous regression/worsening
Usually asymptomatic, but may be slightly painful
Geographic Tongue
Usually no treatment
When painful, baking soda rinses, antifungals, or topical corticosteroids may help.
Geographic Tongue
It is a chronic mucocutaneous disease that is characterized by bilateral white lesions that is associated with ulcers
Lichen Planus
The importance of this disease is related to its frequency of occurrence, its occasional similarity to other mucosal diseases, its occasionally painful and persistent nature, and its possible
relationship to squamous cell carcinoma.
Lichen Planus
cause is unknown, though it is considered to be immunologically mediated process that resembles a hypersensitivity reaction
basal keratinocyte destruction by T cells
Lichen Planus
Buccal mucosa is commonly affected specifically in the posterior and interior regions adjacent to the second and third molars.
This can also be characterized by white keratotic straie
Lichen Planus
Treatment: Observation, topical and systemic corticosteroids, or other
immunosuppressive agents
Lichen Planus
The most common type of Lichen planus is the __________, which is characterized by numerous interlacing white keratotic lines or striae so-called Wickham’s striae) that produce an annular or lacy pattern.
reticular form
The _________ of lichen planus tends to resemble leukoplakia clinically but has a multifocal distribution.
Such plaques generally range from slightly elevated to smooth and flat.
The primary sites for this variant are the dorsum of
the tongue and the buccal mucosa.
plaque form
The _____________ of lichen planus appears as red patches with very fine white striae. It may be
seen in conjunction with reticular or erosive variants.
erythematous or atrophic form
In the ________ of lichen planus, the central area of the lesion is ulcerated. A fibrinous plaque or pseudomembrane covers the ulcer.
erosive form
The disease is an auto-immune disease that involves both humoral and cell-mediated arms of the immune system
Lupus Erythematosus
skin and mucosal lesions are relatively mild, and patients’ complaints are
dominated by multiple organ involvement
Systemic Lupus Erythematosus
Ulceration, erythema, and keratosis may be seen.
In addition to the vermilion, the labial and buccal mucosa, gingiva, and palate are often involved.
Systemic Lupus Erythematosus
On the skin, lesions appear as disc-shaped erythematous plaques with hyperpigmented margins.
Discoid Lupus Erythematosus
has 2 distinct forms: Systemic Lupus Erythematosus and Discoid Lupus Erythematosus
Lupus Erythematosus
Involvement of the skin results in an erythematous rash, classically seen over malar processes and the bridge of the nose
“butterfly” distribution usually associated with
SLE.
topical corticosteroids, Systemic steroids such as prednisone may be combined with immunosuppressive agents for their therapeutic and steroid-sparing effects
Lupus Erythematosus
