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Oral Medicine > White & Red Patches > Flashcards

White & Red Patches Flashcards

1
Q

What layers does mucosa consist of?

A
  • Epithelium
  • Lamina propria
  • Musclaris mucosa
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2
Q

What are the THREE types of gross mucosa?

A
  • Lining
  • Masticatory
  • Gustatory
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3
Q

What are the two types of keratinised epithelium?

A
  • ORTHOkeratinised = anucelar keratin layer

- PARAkeratosis = some nuceli

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4
Q

What are the epithelial strata?

A
  • Stratum corneum
  • Stratum granulosum
  • Stratum spinosum
  • Stratum basale
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5
Q

What are the SIX reactions (of epithelium) in the oral mucosa?

A
  1. Atrophy (reduction in viable layers)
  2. Erosion (PARTIAL thickness loss)
  3. Ulceration (FULL thickness loss)
  4. Oedema
  5. Blister (vesicle/ bulla)
  6. Dysplasia (not seen clinically; disordered growth pattern in cells & tissue as whole)
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6
Q

What factors contribute to atrophy of oral mucosa?

A
  • Age (progressive)

- Nutritional deficiencies - iron, vit b12, folate

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7
Q

List the aetiologies for inflammation

A
  • Trauma (physical/ chemical)
  • Infection (viral, bacterial, fungal)
  • Immunological
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8
Q

Define ‘leukoplakia’ (WHO)

A
  • Clinical description
  • White patch that cannot be scraped off and attributed to any other cause
  • Diagnosis of exclusion, must be biopsied if unexplained
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9
Q

Define ‘erythroplakia’

A
  • Red patch that cannot be rubbed off and attributed to any other cause
  • Atrophic end of spectrum
  • Must be biopsied if unexplained
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10
Q

What are some known causes for white patched in the mouth?

A
  • Hereditary =
    • -> WHITE SPONGY NAEVUS
    • -> FORDYCE SPOTS
  • Smoking/ frictional =
    • -> SMOKER’S KERATOSIS
    • -> FRICTIONAL KERATOSIS
  • Lichen planus
    • -> LICHEN PLANUS
    • -> LICHENOID REACTION
  • Lupus Erythematous
    • -> DISCOID LE
  • Candidal infection
  • Carcinoma
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11
Q

What causes white spongy naevus?

A
  • Autosomal dominant condiditon

- Gene responsible for keratin production and desquamation is mutated

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12
Q

What are Fordyce’s spots?

A
  • Sebaceous glands (inactive) found inside mouth (not usually found there)
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13
Q

What are the characteristics of smoker’s keratosis?

A
  • Pink spots on hard palate (minor salivary glands blocked –> inflamed)
  • Seen in pipe smokers
  • Hyperkeratosis
  • Histology = low chance malignancy, variable dysplasia, minimal infiltrate
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14
Q

What is the similarity and difference between ‘lichen planus’ and ‘lichenoid reaction’?

A
  • SIMILARITY = histologically same

- DIFFERENCE = LP- autoimmune, unknown cause, LR- hypersensitivity reaction, known cause

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15
Q

What is lupus erythematous?

A
  • Connective tissue disease
  • Characterised by skin rash, esp face
  • Red/ white striae on mucosa, esp palate
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16
Q

What are the types of lupus erythematous?

A
  • Discoid = face and oral cavity ONLY

- Systemic = any organ

17
Q

Why must you not depend entirely on biopsy results for suspected lupus erythematous?

A

Histologically similar to lichen planus!

18
Q

Give a list of differential diagnoses for white patches of the oral cavity seen in smokers

A
  • Smoker’s keratosis
  • Hyperplastic candidosis
  • Leukoplakia
19
Q

What are the LOCALISED causes for brown/ black lesions found in the oral cavity?

A
  • Amalgam tattoo
  • Malignant melanoma (pre-malignant lentigo)
  • Macule/ naevus (freckle/mole)
  • Pigmentary incontinence (normal pigm leak into gingivae)
  • Kaposi’s sarcoma
  • Peutz-Jehger’s Syndrome
20
Q

What are the GERNERALISED causes for brown/ black lesions found in the oral cavity?

A
  • Racial/ familial
  • Drugs
  • Addison’s disease (hyperfunctioning adrenal gland –> ACTH same precursor for melanosis –> pigmentation oral cavity)
  • Smoking
21
Q

What is a hamartoma?

A

Benign, localised malformation resembling a neoplasm in tissue of its origin

22
Q

What is a haemangioma?

A
  • Hamartoma

- characterised by rapid growth during first few weeks of life which then usually regresses over the next 10 years

23
Q

What are vascular malformations?

A
  • Congenital vascular abnormalities

- includes lymph nodes, veins and arteries (single entities or combination)

24
Q

What are the types of vascular malformations?

A
  • Capillary
  • Cavernous
  • Sturge-Weber Syndrome
25
Q

What are lymphangionmas?

A
  • Hamartoma
  • benign tumour composed of lymph vessels (dilated & newly formed)
  • Most are cavernous
26
Q

List lesions commonly seen on the tongue

A
  • Geographic tongue (depapillation of filiform papillae)
  • Black hairy tongue (extended filiform papillae)
  • Fissured tongue
  • Glossitis = dry tongue, nutritional deficiency

Oral Medicine (13 decks)

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