White Soft Tissue Lesions (Non-Malignant) Flashcards
What are Fordyce granules?
- ectopic sebaceous glands on oral mucosa
- normal anatomic variation (>80% of population)
- more commonly in adult than children (puberty appears to stimulate dev)
Clinical presentation of Fordyce Granules..
- multiple
- small (1-2mm)
- white or yellow-white papules
- asymptomatic
Location of Fordyce granules?
- buccal mucosa
- lateral portion of vermillion border of lips
- retromolar areas, anterior tonsillar pillar (less common)
Histopathologic findings of fordyce granules..
- resemble sebaceous glands found in skin BUT lacks hair follicles
- acinar lobules seen beneath epithelial surface, communicating w surface via central duct
- sebaceous cells in lobules
- polygonal shape
- centrally located nuclei
- abundant foamy cytoplasm
Management of fordyce granules?
- NO treatment needed
- can laser off if aesthetics is a concern
What is leukoedema?
- common oral mucosa condition of unknown cause
- more common in blacks than whites (more noticeable in blacks due to background mucosal pigmentation)
Clinical presentation of Leukoedema..
- folded surface => wrinkles & streaks
- diffuse, greyish-white, opalescent
- does not rub off, but disappears on stretching of mucosa
Locations where Leukoedema occurs..
- bilateral buccal mucosa
- floor of mouth (rare)
Histopathology of leukoedema..
- acanthosis: increased thickness of epithelium & elongation of rete ridges
- intracellular oedema (keratinocyte oedema) of spinous layer
- large vacuolated cells w pyknotic nuclei
Management of Leukoedema..
NO treatment needed, benign condition
Leukoedema can be confused w..
Leukoplakia, OLP, oral candidiasis, submucous fibrosis
What is Benign Alveolar Ridge Keratosis (BARK)?
- Chronic mechanical irritation
- Due to:
- opposing dentition
- reaction to trauma of impacted food on mucosa
Clinical presentation of Benign Alveolar Ridge Keratosis (BARK)?
Poorly demarcated white plaque, commonly found on the keratinised mucosa of alveolar ridge, retromolar pad
Histopathologic findings of Benign Alveolar Ridge Keratosis (BARK)?
- Hyperkeratosis & acanthosis
- Keratinocyte oedema
- No/mild inflammatory infiltrate
- No dysplasia
Management of Benign Alveolar Ridge Keratosis (BARK)?
NO treatment needed, no malignant potential
What are the 2 types of frictional hyperkeratosis?
- Linea Alba
- Morsicato Buccarum (Chronic mucosal chewing)
What is Linea Alba?
- Female predominance
- Due to frictional irritation from repetitive interdigitation of teeth (cheek biting)
Clinical presentation of Linea Alba..
- Usually bilateral
- uniform, adherent horizontal white line
- rough & frayed surface
- may be scalloped
- more prominent adjacent to posterior teeth
Location of Linea alba..
Buccal mucosa, along occlusal plane
Management of Linea Alba
- NO treatment needed, no malignant potential
- Spontaneous regression may occur
What is Morsicato Buccarum (Chronic mucosal chewing)?
- common, unintentional habit of cheek biting
- across all ages
Clinical presentation of Morsicato Buccarum..
- Usually bilateral
- shredded, white area
- irregular ragged surface w tags of epithelium that peel off
- may have erythema, erosion or ulceration
- more prominent at anterior buccal mucosa
Morsicato Buccarum is commonly found on..
Buccal mucosa, lateral border of tongue, labial mucosa (rare on upper lip mucosa)
Management of Morsicato Buccarum..
NO treatment needed, no malignant potential
- preventive therapy: use acrylic shield to separate teeth form adjacent mucosa => quick resolution
