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56 Cards in this Set
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- Back
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Hyper plastic, etiology unknown, oral mucosa, 2X females, age 40-70, well demarcated, white/yellow, warty, lipid laden (foamy), MACs in c.t. Papillae. Tx?
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Tx w conservative excision
Verruciform Xanthoma |
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Benign proliferation of basal cells
- not in mouth, raised waxy "stuck on" - 4th decade, sun exposure, hereditary? - dermatitis papulosa n. 30% blks - leser trelat sign, multiple seb k's with int. malignancy |
Seborrhic Keratosis
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-self limiting epi mimics scc
-sessile, dome shaped, central keratin plug - big in 6 wks, then 6-12 mo regression -sun skin mostly men, tx? |
Excise
Keratocanthoma |
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- common benign skin lesion
- on face, cheeks, forehead - soft nodule, normal/yellowy depressed center - mimics bcc - normal sebaceous gland, little enlarged |
Sebaceous hyperplasia
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- white lesions on mucosa bc snuff
- site where tobacco sits - filmy white to white dense & fissured - old people - oral cancer X4 risk |
Smokeless tobacco keratosis
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- progressive fibrous scarring of mucose in tobacco, areca, & betel users
- seen in india - unable to open mouth (advanced cases) - doesn't regress if habit stopped high risk precancer (epithelial dysplasia 10%, carcinoma 6%) |
Oral Submucous Fibrosis
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- seen in palatal mucosa, pipe/cigar smokers
- white hyperkeratotic lesions/red salivary duct orifaces - due to heat, not premalignant - will completely regress in couple wks after smoking stops - palatal lesions by reverse cigarette smoking are premalignant |
Nicotine Stomatitis
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- common skin lesion seen on sun exposed skin (fair skin, lifelong sun)
- irregular scaly plaque, face, neck, hands, forarms, bald head - 25% to SCC hyperkeratosis and basophilic degeneration tx? |
tx: cryotherapy, electrodissication, curettage & excision
Actinic Keratosis |
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similar to actinic keratosis, but on mucosa, lower lip often
- fair skinned, over age 45. 10X males - blotchy pale areas w/ blurring vermillion border - epi atrophy, solar elantosis, hyperkeratosis - premalignant - ulcer may herald cancer |
Tx: sunscreen, biopsy suspicious areas
Actinic Cheilosis |
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white line on buccal mucosa
-bilateral, in dentulous areas - frictional, pressure or sucking trauma from facial surfaces of teeth - 13% of population tx? |
no tx needed
Linea Alba |
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white shaggy appearance to buccal mucosa
-chronic habit of chewing mucosa -2X females, 3X after age 35 - similar lesions tongue or labial ucosa |
Morsicatio Buccarum
("cheek biting") |
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mechanical injury b/c chewing, sharp food/other trauma
- tongue, lips buccal mucosa most common sites - may last long time, minics carcinoma clinically - mimics lymphoma microscopically - biopsy leads to healing |
traumatic ulcers
traumatic granuloma |
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- chewing on electric cord
- young kids - 5% burns seen in hospital Thermal b/c hot food/drink, resolve w/o Tx |
Oral Burns/ Thermal Burns
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- due to self tx often
- often aspirin, h202, silver nitrate, phenol, endo materials, cotton rolls - best tx is prevention |
chemical injuries
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acute oral complications -
(mucositits, hemorrhage) chronic oral complications - zerostomia, hypogeusia (loss of taste) - osteoradionecrosis, trismus, chronic dermatitis - developmental abnormalities |
noninfectious complications of antineoplastic tx
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raised lesion, pedunculated, multiple papillary projections
- infection b/c HPV - pappilary b/c hyperplasia of epi, color: pink to white - any age, tongue uvula, lips, buccal mucosa, gingiva, palate |
sqamous papilloma
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- virus may cause induced retardedness in small infants. common w/ immunosupressed - 80%adults have antibodies to virus (unsure when infectd) - many kids who die under age 2 exhibit disease
- detected inpts' that are debilitated due to chemo,m leukemia, weak immune sys - causes pathognomonic morphologic appearance to nu that appears as inclusion. classically in salivary gland, also in other organs - dx via urine samples |
Cytomegalovirus
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RNA virus of picornovirus group.
- responsible for 3 disease entities in young kids, all oral-pharyngeal lesions. what is it. what are the 3? |
Coxsackie A
1. herpangina 2. acute lymphonodular pharyngitis. 3. hand food & mouth disease |
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seen in community in sporatic outbreaks in kids in summer. flu like symptons, sm. vesicles in hard/soft palate, pharynzx, tonsilar pillars, tongue & buccal mucosa.
- incubation 2-10 days, ulcers heal w/in few days to a wk. |
herpangina
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caused by coxsackie A10
- kids/young adults, sore throat, temp 100-105' - broad raisedwhite/yellow papules (not vesicular/don't ulcerate) - uvula, soft palate, anterior tonsils & post orpharnx. - 2-10 days incubation, lasts 4 to 14 days |
acute lymphonodular pharyngitis (ALP)
" you got the alp's" |
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- coxsackie A16 (6mo-5yrs)
- maculopapular, exanthematous & vesicular lesions of skin. seen hands/feet w/ vesicular/ulcerative oral lesions of hard palate/tongue/buccal mucosa - disease self limiting, gone 1-2 wks. - looks like herpes. serologic testing or viral culture helps |
hand, foot and mouth disease
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Rare in USA b/c vaccine.
-occasional peidemis when a non-immune population lg enough -highly contageous (incubates 10-12 days) - feel: fever, malaise, coryza, conjuctivitis, cough, rash on face, trunk, extremities, oral lesions - koplick's spotsw |
Rubeola (measles)
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Mild viral illness, MMR make less common
- congenital can mean deaf, heart disease, cataracts - feel fever, malaise, anorexia, conjunctivitis, coryzaq, cough, lymphademopathy, rash starts head/neck, to body, fades as spreads, orally : frochheimer's sign |
rubella
(german measles) |
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acute viral disease effects salivary glands. parotids. live attenuated vaccine helps.
feel: headache, fever, vomitting and pain in parotids, firm swelling of salivary glands, pain in mastication - in adults serious. other organs (testes/ovaries/pancreas/ mammary glands/prostate at risk) can cause sterility -seldom fatal, gone in 1 wk |
mumps
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acuta viral syndrome - like mono initially
- many 2ndary infections & neoplams - infection orally: viral, bacterial or fungal |
Human immunodeficiency virus
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following injection, necrosis & ulceration b/c pressure & vasoconstrictor.
usually heals w/o tx |
Anesthetic necrosis
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biting, picking/sucking on lips
cracked, irritated lip, involve perioral skin -87% psychiatric condition, 47% thyroid dysfunction femail prodominance |
exfoliative chelitis
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____- minute hemorrhages into skin/mucosa
____ - slightly larger hemorrhages ____ - hemorrhages over 2cm ____ - pooling of blood in tissue to produce mass |
submucosal hemorrhages
petechiae - minute hemorrhages into skin/mucosa purpura - slightly larger hemorrhages echymosis - hemorrhages over 2cm hematoma - pooling of blood in tissue to produce mass |
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petechiae @ jxn of hard/soft palate
- due to negative pressure & forceful thrusting, may be recurrent |
fellatio
(oral trauma from sexual practices) |
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acute lesion is ulcer on lingual frenum
- chronic activity m ay lead to linear fibrous hyperplasia on lingual frenum |
Cunnilingus
(oral trama from sexual practices) |
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amalgam into tissues during tx
- appear gray to blue/black, spreads laterally - radiographically seen, consider melanocytic neoplasm |
amalgam tattoo
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tattooing by traumatic implantation - asphalt, graphite, shrapnel
- or decoratively, 25% world population, maybe done to facilitate tx |
Other Traumatic or Intentional tattoos
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Pb - paint/pipes
Hg - med's, amalgam, liquid spills Ag - industrial, meds (old) Bismuth/arsenic - industrial, meds (past) Au - meds |
systemic metallic intoxication
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Abdominal colic, anemia, fatigue, irritability, weakenss, encephalopathy/renal dysfunction
- chronic fatigue, muscle pain, headache, kidney, joints, bone CNS dysfxn |
lead poisoning (whole body)
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oral pigmentation (pb line)
tremor of tongue advanced perio disease excessivie salivation metallic taste |
Pb Poisoning (oral findings)
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21.5% heavey smokershave white areas of oral melanin pigmentation
- females more - heavy pigmentation seen in reverse cigarette smokers - most commonly affects anterior facial alveolar mucosa in smokers |
smokers Melanosis
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___ - for malaria, lupus erythematosis, rhumatoid arthritis
__- laxative ___ - most w chlorpromazine __- doxorubicin, cyclophosphamaide, 5-fu |
drug related discolorations of oral mucosa
antimalarial meds - for malaria, lupus erythematosis, rhumatoid arthritis phenolphthalein - laxative tranquilizers - most w chlorpromazine chemotherapeutic agents - doxorubicin, cyclophosphamaide, 5-fu |
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ill fitting dentures, 2ndary to chronic truams in epulis fissatum
- tender nodule presentation - show bone/cartilage formation (misdx as chondrosarcoma) |
traumatic osseous & chondroid metaplasia
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- common on panoramic radiograph (up to 10% population) dome shaped, faintly radiopaque, floor of max sinus
- not to be confused w/ sinus mucocele, surgical ciliated cyst, or sinus retention cyst |
antral pseudocyst
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intro of air into subcutaneous or fascial spaces
- 2ndary to dental procedures compressed air, prolonged exo's, increased intraoral pressure after surgery - idopathic -tx w? |
Cervicofacial emphysema
tx w antibiotics & observation |
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unique foreign body rxn
- b/c palcement of topical tetracyclkilne in petrolium base into surgical defect - seen in exo sites - microscopically: black "axle grease" appearance, "bag of marbles" black/brown - pas thought fungas infection |
Myospherulosis
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causation: allergies, genetic, hematologic abnormalities, hormonal influences, infectious agents, nutritional imbalances, trauma, stress
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recurrent apthous stomatitis
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causitive factors:
1' immunodysregulation, decrease of mucosal barrier increase in antigenic exposure clinically? |
categoris of causative factors of
Recurrent Apthous Stomatitis clinically: minor, major, or herpetiform |
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combination of chronic ocular inlammation & orogenital ulcarations, seen on "silk road"
- mouth, genitals, skin, joints, eyes, cns - ocular mucocutaneous, arthritic & neurologic |
Behcet's Syndrome
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multisystem granulomatous disorder, unk cause
10X in black, lil' more female predominance - many organs, eps lungs, lymph nodes, eyes, saliva galnds - 20% w/o symptoms, otherwise lasts days/weeks only elevated ACE (angiotension converting enzyme) - biopsy of saliva gland dx |
Sarcoidosis
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Form of acute sarcoidosis
- parotid enlargement - anterior uveitis - facial paralysis - fever |
heerfordt's syndrome
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form of acute sarcoidosis
erythema nodosum bilateral hilar lymphadenopathy arthralgia |
lofgren's syndrome
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granulomatous inflammation of oral/facial regions
- dx by exclusion - presents as "cheilitis granulomatosa" or "melkersson-Rosenthal synd" idiopathic, yet bacterial cause is possible |
orofacial granulomatosis
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cheilitis granulomatosis
facial paralysis fissured tongue |
Melkersson-Rosenthal Synd
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chronic granulomatous disease
chrohn's disease hairy cell leukemia mycobacterial infection sarcoidosis |
systemic processes associated w oral granulomatous inflammation
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well recognized, uncommon, idiopathic
may involve any organ system, classic: upper & lower resp tract involvement along renal "strawberry gingiva" - oral involvment - ulceration mixed inflammationinvolving blood vessels indirect immunofluoresence (cANCA & pANCA) tx? |
Wegener's Granulomatosis
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erythema multiforme
- anaphylatic stomatitis - intraoral fixed drug eruptions lichenouid drug rxns' lupus erythematosis like-eruptions - pemphigus like drug eruptions non-specific vesiculoulerative lesions |
Allergic Mucosal Reactions to Systemic Drug Administration
(stomatitis Medicamentosa) |
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many agents may cause allergic contact stomatitis
- cinnamon & amalgam may cause unique patterns - rarely caused by dental materials - oral mucosa less sensitive than skin(brief contact period, saliva dilutes, rapid dispersal & absorption of antigens) |
Allergic Contact Stomatitis
(stomatitis Venenata) |
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fairly common
toothpaste results in diffuse lesions chewing gum & candyresults in more localized lesions lesions red/keratinized or ulcerated pain/burning common |
contact stomatitis from cinnamon flavoring
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mucosal rxn's to chronic contact w dental amalgam
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- adverse affects to dental amagal are rare
- chronic rxn's to contact are rarer & are usually due to mercury - occurs only where there is contact w restoration - clinically & micoscompically looks like lichen planus - should resolve when amagam removed |
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diffuse edematous swelling of soft tissues
usually submucosal(subcutaneous) tissue but may involve GI/resp tract most common in mast cell degranulation (IgE hypersensitivity, physical stimuli) maybe caused by 1. ace inhibitors, 2. defects in C1 esterase inhibitors |
angiodemema
(angionecrotic edema) |
