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56 Cards in this Set
- Front
- Back
what is Hyperkeratosis
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thickened keratin layer of the surface epithelium. like a calus
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Hyperorthokeratosis
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epithelium has a granular layer and the nuclei are lost in the keratin layer
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Hyperparakeratosis
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there is no granular cell layer and the epithelial nuclei are retained in the keratin layer
(remnant exists on outer) |
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Spongiosis
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intercellular edema of the spinous cell layer
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Acanthosis
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thickened spinous layer. DON’T GET CONFUSED WITH ACANTHOLYASIS
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Epithelial dysplasia
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changes in size, shape and
organization of adult cells. begins in the basilar portions of the epithelium. |
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Verrucous hyperplasia
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a type of papillary, exophytic proliferation of squamous epithelium “FINGERLIKE”
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Oral areas that are keratinized
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1) Hard palate
2) Gingiva 3) Alveolar mucosa 4) Dorsal tongue |
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Oral areas that are non-keratinized
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1) Buccal mucosa
2) Buccal vestibule 3) Labial mucosa 4) Labial vestibule 5) Floor of mouth 6) Lateral tongue 7) Soft palate 8) Gingival sulcus |
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is it oral keratinized or non keratinized that are more vulnerable to malig
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non-keratinized
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clincial features of Leukoedema? who gets it more?
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-common, painless and persistent.
considered a normal variation (not a neoplasm) -it appears to be more prominent in blacks (70-90%) and dark-skinned -bilateral -buccal mucosa shows a diffuse filmy milky opalescence -mucosa may appear somewhat folded, or wrinkled *white appearance disappears when tissue is stretched -may also involve floor of mouth |
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etiology of leukoedema
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not know. but seen more in smokers
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histology of leukoedema
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acanthosis, parakeratosis and intracellular edema
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tx for leukoedema
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none since non malig. but should look to make sure it is not leukoplakia
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Differential diagnosis for leukoedema
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keratosis
white sponge nevus smokeless tobacco lesions cheek-biting lesions |
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clinical features for Linea Alba
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white line along buccal mucosa in region of occlusal plane
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Histology for linea alba
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hyperorthokeratosis, intracellular edema
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etiology for linea alba
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may be due to biting buccal mucosa or negative pressure due to habits such as sucking cheeks
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clinical features for Squamous Papilloma: what is it? what does it look like? where does it usually reside? who is more at risk? what color is it?
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-exophytic (ABOVE SURFACE), “cauliflower-like” soft lesion, WHITE
-usually a few mm in diameter (0.5 cm) but up to 1.5 cm -pedunculated or less commonly sessile -usually found on tongue, lips, buccal mucosa, gingiva and palate (palate and uvula account for 1/3 of lesions) -seen at any age (usually adults) -may be white or pink (depends on amount of hyperkeratosis) |
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what is the most common oral lesion
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squamous papilloma
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Etiology of squamous papilloma
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Human Papilloma Virus(HPV)- especially subtypes 6 & 11
(low virulence and infective rate) (3 to 12 month incubation period) - transmitted by person to person contact, etc. |
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Histology of squamous papilloma
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-long thin finger-like projection of squamous epithelium
containing a thin connective tissue core -may show hyperkeratosis |
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Treatment for squamous papilloma
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1) excisional biopsy (including base of lesion)
2) recurrence and dissemination to other parts of body rare 3) malignant transformation rare 4) vaccine targeted for HPV types 6, 11, 16 and 18 |
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Differential diagnosis for squamous papilloma
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1) verruca vulgaris
2) verrucous carcinoma 3) condyloma acuminatum 4) verruciform xanthoma 5) etc. |
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Clinical features of Verrucous Vulgaris
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1) common, painless and persistent
2) wart-like with sessile base 3) has finger-like projection 4) may be white or normal in color 5) some may show a keratin horn |
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who is prone to Verrucous Vulgaris? where is it usually?
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-children and young adults
-oral lesions often seem on vermillion border, labial mucosa and anterior tongue -may spread to other parts of body, especially fingers (contagious) -commonly found on hands and fingers of children |
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Etiology Verrucous Vulgaris
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human papilloma virus, HPV-2, HPV-4, HPV-6 and HPV-40
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Histology Verrucous Vulgaris
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1) pointed projections from surface epithelium (FINGER LIKE PROJECTIONS. NOT PEDUNCULATED)
2) thickened keratin 3) viral inclusion may be seen in upper spinous layer 4) inflammation in connective tissue 5) MULTIPLE NOT JUST BY ITSELF |
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Treatment of Verrucous Vulgaris
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excisional biopsy, laser, cryo therapy
-some disappear spontaneously (⅔ within 2 years) |
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Differential Diagnosis for verrucous vulgaris
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same as squamous papilloma
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Condyloma Acuminatum also know as Venereal Wart. what is the etiology
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- Human papilloma virus group HPV-2, (HPV-6, HPV-11, HPV-16, HPV-18, HPV-53, HPV-54 and HPV 31)
- incubation period 1 to 3 months after sexual contact |
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verrucous vulgaris is what kind of wart
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Common Wart
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how do ppl get Condyloma Acuminatum
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sexually transmissible and autoinoculable viral disease (STD)
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tx for condyloma acumintam
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Excisional biopsy
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what does Condyloma Acuminatum look like?
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-soft papillary nodules that proliferate rapidly in size
-white or pink -up to 2 cm in diameter (larger than squamous papillomas) |
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where can you usually see Condyloma Acuminatum.
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-anogenital skin (can occur in mouth)
-multiple, papillary masses involving tongue,buccal mucosa, palate, gingiva |
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For Condyloma Acuminatum, in anogenital areas, those infected with HPV 16 and HPV 18 are associated with an increase in what?
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squamous carcinoma
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WHAT IS A KOILOCYTE?
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???
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who gets Focal Epithelial Hyperplasia (Heck's disease)
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-children (ages 3 to 18) and middle-aged adults
-1st observed on American Indians, but also ethnic groups affected |
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what does focal epithelial hyperplasia look like?
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-flattened multiple nodular lesions usually on lower
lip, but also seen on buccal mucosa, commissures, upper lip and tongue -lesions usually 1 to 5 mm in diameter -same color as adjacent mucosa |
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Heck's disease is common in what age?
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children
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etiology of Focal Epithelial Hyperplasia
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may be of viral origin (human papillomavirus types 13 and 32)
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Histology of Heck's disease
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-acanthosis
-mitosoid cells are sometimes seen in squamous epithelium |
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tx for focal epithelial hyperplasia
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none unless want to move it for aesthetic reasons
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Differential Diagnosis for heck's disease
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Squamous papilloma OR MULTI FIBROMA
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Verruciform Xanthoma looks like what?
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1) characterized by lipid-laden histiocytes beneath epithelium
2) uncommon, painless and persistent 3) usually solitary lesion up to 1.5 cm in diameter 4) sessile or pedunculated base 5) normal or reddish in color or may be hyperkeratotic 6) rough or pebbly surface |
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who gets Verruciform Xanthoma
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patients over 40 years of age (1:2, M/F ratio) MORE FEMALE
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where do you see Verruciform Xanthoma
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lower alveolar ridge, palate, floor of mouth, lip, genitalia, etc.
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etiology Verruciform Xanthoma
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unknown (probably not HPV) may be an unusual response to injury
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Histology Verruciform Xanthoma
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1) verrucous hyperparakeratotic surface with elongated rete ridges
2) large swollen "foam" cells (histiocytes and xanthoma cells) in connective tissue papillae between epithelial pegs |
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Treatment for Verruciform Xanthoma
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1) excisional biopsy
2) usually no recurrence 3) no malignant tranformation |
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Differential Diagnosis for Verruciform Xanthoma
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1) Squamous papilloma
2) Condyloma acuminatum 3) Early carcinoma |
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summary Verruciform Xanthoma
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-SOLITARY LESION,
-NOT COMMON, -RED PEBBLE LIKE SURFACE, -FOUND ON SKIN OR GENITALIA, -HAS FOAM CELLS (XANTHOMA CELLS-MACROPHAGES) |
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summary for Focal Epithelial Hyperplasia (Heck's disease)
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-VIRAL ORIGIN,
-YOUNG PPL, -MULTI LESIONS SEEN, -CONSIDERABLE ACANTHOSIS |
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summary for Condyloma Acuminatum
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-20% OF ALL STDS DX,
-CAN AUTOINOCULATE TO OTHER PARTS OF THE BODY -THEY TEND TO BE LARGER THAN PAPILLOMA, -CONDYLOMATAS INFECTED WITH HPV 16 AND 18 HAVE AN INCREASED RISK OF MALIG TRANSFORMATION -VERY CONTAGIOUS |
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summary for Verrucous Vulgaris
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-CAN SPREAD TO OTHER PARTS, -HPV CAUSED,
-HAS KERATIN HORN AND FINGERLIKE PROJECTIONS |