White Patches Flashcards
What is hyperkeratosis ?
This is the development of a keratinised layer at a site that is not normally keratinised
Or
it is a thickening of an existing keratinised layer
What is leukoplakia?
it is defined as a white patch or plaque that cannot be rubbed off and cannot be characterised clinically or histologically as any other disease
What is leukoedema?
white, grey or milky white edematous lesion of the buccal or labial mucosa
What are the main classes of white patches ?
- those that can be rubbed off
- those that are adherent to the oral mucosa
Give examples of causes of white patches that can be rubbed off
- candida albicans
- necrosed or dead mucosa that is sloughing from the underlying base
- collected food debris in patients with poor oral hygiene
Adherent white pathces can be divided into …
- developmental lesions
- acquired lesions
Give examples of developmental white patches
- fordyce granules
- geographic tongue
- white sponge naevus
- tylosis
- dariers disease
What are fordyce granules ?
these are slightly raised sebaceous glands (secrete sebum) that are found in hairless areas of the skin.
They are commonly found in the cheeks and the vermillion (borders of the lips)- labial and buccal mucosa
What is the potential significance of fordyce granules?
If they have not been previously noticed (by dentist or patient) then they give rise to concerns of oral cancer
What is the alternative name of geographic tongue? Why is is it given this name?
erythema migrans
this is due to the characteristic appearance and the variable parts of the tongue that are affected at different times
Briefly describe the appearance of white sponge naevus
white, shaggy, folded appearance
What is the pattern of inheritance for white sponge naevus?
autosomal dominant
White sponge naevus has a variable ________. What does this mean?
Penetrance
This refers to the proportion of people with a particular genetic variant who exhibit signs and symptoms of the genetic disorder.
(thus people with the genetic variant may not present with the white spinge naevus?)
What white patch can be seen in children?
white sponge naevus
What is tylosis?
it is a rare autosomal dominant disorder that affects the oral mucosa but more commonly the palms and soles of the feet.
What is Dariers disease?
Autosomal dominant disorder which is mucocutaneous.
mucocutaneous pertaining to where the mucosa and skin meet
The _____ mucosa accounts for 50% of Dariers disease.
oral mucosa
Where are lesions of the oral mucosa often found in Dariers disease?
the palate
Give examples of acquired white patches
- Traumatic
- infective
- viral
- idiopathic
What is the most common cause of acquired white patches?
mechanical trauma
Where is the most common site of mechanical trauma in the oral mucosa?
- buccal mucosa
- lateral margins of the tongue adjacent to the occlusal plane
Give instances where masticatory trauma occurs (leading to white patch development)
- edentulous ridges opposing natural dentition under an ill-fitting denture
- edentulous patients who do not wear dentures
When can chemical trauma of the mucosa lead to white patch development?
secondary to/following necrosis of the oral mucosa
Give an example of an instance that can lead to chemical trauma of the oral mucosa
Aspirin held in the mouth, typically against the cheek