Oral Path Lecture 3 Notes

Front 1

What is a clinical term to describe a red patch?

Back 1

Erythroplakia

Front 2

What type of Pt might you see erythroplakia in?

Back 2

A chronic tobacco/alcohal user

**This is a possible pre-maligancy 85% of the time.**

Front 3

Is erythroplakia inflammatory in nature?

Back 3

No!

Front 4

What type of TX might be considered for erythroplakia?

Back 4

Removal of the lesion,
Chemo/radiation,
Close follow up

Front 5

What is a clinical term to describe a collection of blood within tissue space?

Back 5

Hematoma

Front 6

Will a hematoma blanch?
Why or why not?

Back 6

No, because its not a vascular lesion.

Front 7

What is a hemangioma?

Back 7

A benign proliferation of blood vessels.

*Remember, is seen in young children/infants*

Front 8

What might a red or brown lesion be an indicator of?

Back 8

Possible maligancy.

Front 9

What is Telangiectasia?

What age group is more likely to have it?

Back 9

Spider veins in the face.

Typically more in the elderly but = in males/females.

Front 10

What is erythematous candidiasis?

Back 10

A common, red looking, candidiasis.

(May look like herpes if on commisures)

Front 11

Candidiasis can appear as ________ & ________ lesions.

Back 11

Red & White.

Front 12

Patients who have ____________are often more likely to experience Erythematous Candidiasis.

Back 12

Dentures

*Be sure the PT is cleaning them regularly, may need to disinfect.*

Front 13

Which populations would Oral Submucous Fibrosis be found in?

Back 13

Usually in developing countries, but with immigration it is being seen more in the US.

Front 14

What does Oral Submucosis Fibrosis look like?

What is a DD of it?

Back 14

Has a white marble appearance in the buccal mucosa.

DD: lichen planus

Front 15

What are 2 pigmented lesions that are variants of normal?

Back 15

Amalgam Tattoo Oral Pigmentation

Front 16

What might the tissue around a titanium implant look like?

Back 16

Grey-blue tissue around the gingiva.

(The tissue is so thin the metal shows through.)

Front 17

What type of pigmentation would have Grey, Blue or Black around the gingival margin?

Back 17

Heavy metal pigmentation.

Front 18

What are 2 examples of medications where pigmentation is involved?

Back 18

Minocycline tetracycline

Front 19

What is another name for Minocycline tissue staining?

Back 19

Black bone staining

Front 20

What is another name for a benign mole?

Where in the oral cavity is likely to be found?

Back 20

Nevus

The hard palate is the most common intraoral site.

Front 21

What is the DD for a Nevus?

What is the TX?

Back 21

DD: Amalgam tattoo, melanoma, hemangioma

Tx: Monitor

Front 22

Wht is the term for a freckle on the lip?

Back 22

Ephelis (macule)

Front 23

How would you describe an oral melanoma?

Back 23

Its usually located on the hard palate and maxillary gingiva. Usually has irregular/asemmetical boarders. Usually dark in color

Front 24

Who is more likely to have an oral malanoma?

Back 24

Men 40+, Can be deadly so keep an eye on it.

*Always investigate a dark lesion.*

Front 25

How might someone get Frictional Keratosis?

Back 25

Cheek Biting, Ortho Tx, Broken or Missing teeth, Bruxing

Front 26

Is Frictional Keratosis rare or common?

Back 26

Common

Front 27

Why can't you just wipe it off?

Back 27

Keratin is produced to protect the site and won't simply wipe away.
The condition must be alleviated.

Front 28

What is the DD for Frictional Keratosis?

Back 28

Leukoplakia, Lichen planus, hyperplastic candidiasis.

Front 29

What is the most common white lesion in pipe or heavy smokers?

Back 29

Nicotine Stomatitis

Front 30

What is nicotine stomatitis?

Back 30

Hyperkeratosis on the palate with possible inflamed minor salivary gland ducts.
(Looks like red or brown spots in the keratin)

Front 31

Although its relatively rare, which population would you see chemical burns?

Back 31

The elderly.

Often from sucking on an asprin to alleviate a toothache.

Front 32

Thermal burns are a result of?

Back 32

Hot Food!

Front 33

What might a chemical or thermal burn look like?

Back 33

Localized white plaques.

DO NOT RUB THEM OFF--can cause raw or bleeing "under tissue".

Front 34

What is the DD for Chemical/Thermal burns?

Back 34

Frictional keratosis, hyperplastic candidiasis, lichen planus

Front 35

What is Candidiasis?

Back 35

A fungal infection caused gy the Candida C. albicans

Front 36

Where can candidiasis be found?

Back 36

Mouth, GI tract & vagina.

(Same bacteria can be in all locations)

Front 37

What type of infection is candidiasis?

Back 37

Opportunistic!

*You might see this in Pt's with asthma in the back of the throat due to the inhaler*

Front 38

What is the usually appearance of candidiasis?

Back 38

White apperance but has an erythematous form as well.

Front 39

If the candidiasis is wiped off what will the appearance be?

Back 39

Red, ulcertative look to the underlying tissues.

Front 40

What is the Tx for this fungus?

Back 40

Antifungal

Front 41

What is another name for Acute pseudomembranous candidiasis?

Back 41

Thrush

Its common in newborns.

Front 42

Where would Thrush be located?

Can it be wiped off?

Back 42

It has both extra and intra oral characteristics.
(Can often be found in skin/fat folds)

Yes it can be wiped off, a bleeding base is rare.

Front 43

DD?

Tx?

Back 43

Most lesions that wipe off are candidiasis.

Tx: antifungal

Front 44

How would you treat dentures or partials for a Pt with acute pseudomembranous candidiasis?

Back 44

They need to be disinfected so as to avoid re-infecting the area.

Front 45

What is the rarest form of candidiasis?

Back 45

Chronic Hyperplastic Candidiasis

** It is the only form to show possibility of pre-malignancy in a low amount of cases**

Front 46

What characteristic of Chronic Hyperplastic Candidiasis is unlike other forms of candidiasis?

Back 46

It won't rub off!!

(Has a thick, raised, white plaque.)

Front 47

What disease states is Hairy Leukoplakia associated with?

Back 47

EBV (Epstein Barr Virus) and HIV.

Front 48

What is the most common site for Hairy Leukoplakia?

Back 48

Lateral boarder of tongue, often is Bilateral!

Won't wipe off!

Front 49

What would be the DD of Hairy Tongue?

Back 49

Frictional keratosis, lichen planus, candidiasis, possible burns.

Front 50

What is the origin of Lichen Planus?

Back 50

This inflammatory disorder has an unknown cause.

Front 51

Which sex is more likely to have lichen planus and what surface is it usually located?

Back 51

Female 90%

Buccal mucosa

Front 52

What conditions can exaserbate lichen planus?

Back 52

Stress & Anxiety

Front 53

What are the 6 forms of Lichen Planus? Which is most common?

Back 53

1) Atrophic (red patches with white)
2) Bullous
3) Erosive (angry red ulcerated look)
4) Papular
5) Plaque like
6) Reticular- Wickam striae **Most common form**

Front 54

What is White Sponge Nevus?

Back 54

A mutation in the keratin gene. It's genetic

Front 55

Is White Sponge Nevus usually seen laterally or bilatterally?

Will it rub off?

Back 55

Most often bilaterally.

No it won't rub off.

Usually is located on the buccal mucosa.

Front 56

DD For White sponge nevus? Tx?

Back 56

DD: Cheek Chewing, Lichen planus, leukodema Tx: None