White patches, Red patches and Pigmented lesions

Question 1

Causes for oral lesions to appear white?

Answer 1

Congenital
Lichen planus
Infections
Neoplastic
Keratosis

Question 2

What is Leukoedema

Answer 2

Normal physiology
Faint white lines on buccal mucosa
African heritage

Question 3

What is White sponge Naevus

Answer 3

Inherited autosomal dominant
Mutated keratin gene 4&13
Buccal mucosa
Benign

Question 4

Histological features of White sponge naevus

Answer 4

Acanthotic
Hyperkeratosis
Intracellular oedema in stratum spinosum and parakeratinised layers

Question 5

Genodermatoses

Answer 5

Rare autosomal dominant
Hyperkeratosis papules affecting H&N
Primarily palatal and alveolar mucosa

Question 6

Focal palmoplantar and oral mucosa hyperkeratosis syndrome

Answer 6

Autosomal dominant
Usually keratinised tissue

Question 7

Hairy leukoplakia

Answer 7

Bilateral on lateral aspects of tongue
Results from EBV infection will present in HIV, Diabetes, Steroid use

Question 8

SCC red flags

Answer 8

Exophytic
Indurated
Non-homogenous
Non-healing
Numbness
Tethering of tissue

Question 9

Management of SCC

Answer 9

URGENT REFERRAL TO OMFS
Follow local guidelines
Inform patient honestly
Explain biopsy

Question 10

High risk factors for malignant transformation

Answer 10

Size: >200mm^2
Non-homogenous
Red/ Speckled
Tongue and FoM

Question 11

Management for OPMD

Answer 11

Smoking cessation
Increase fruit and vege intake
Mapping biopsies
Observation with clinical photos
If moderate/ severe dysplasia, excision

Question 12

Types of keratoses?

Answer 12

Frictional
Thermal
Chemical

Question 13

Linea alba management

Answer 13

Identify the cause
Correct the cause and review 2-3 weeks
If no improvement consider referral or biopsy

Question 14

White patch general management strategies

Answer 14

can wipe away?
Get photos
No improvement REFER
Still worried or worsening, BIOPSY
finished at slide 33