Oral Pathology 1

Front 1

Squamous Papilloma

Back 1

- Most common benign epithelial neoplasm seen intraorally, HPV-associated (6,11)
- Solitary lesions, often found on soft palate/uvula or tongue
- Papillary fronds; usually pedunculated, may be sessile
- Range of color (reddish to white)

Front 2

Papilloma Histology

Back 2

- Often pedunculated but sometimes sessile
- Papillary proliferation of surface epithelium
- Variable production of surface keratin
- Epithelial proliferation supported by finger-like projections of fibrous CT

Front 3

Papilloma Tx

Back 3

- Conservative excision
- Excellent prognosis
- Recurrences are uncommon; no risk of malignant transformation

Front 4

Verruca Vulgaris

Back 4

- AKA "common warts"
- Lesion caused by several strains of human papillomavirus
- Frequently affects children- hands and facial skin
- Usually sessile, exophytic, papillary lesion; often multiple (!)

Front 5

Verruca Vulgaris Histo

Back 5

- Papillary hyperkeratotic epithelial proliferation
- Coarse, clumped keratohyaline granules
- Koilocytosis

Front 6

Verruca Vulgaris Tx

Back 6

- Spontaneous regression common in kids
- Excision, cryotherapy, keratolytic agents
- May recur

Front 7

Condyloma Acuminatum

Back 7

- "venereal warts"
- Spread by direct contact
- Oral lesions: labial mucosa, soft palate, lingual frenum
- Caused by sever trains of HPV including 6, 11, 16, and 18 (high risk strains assoc. w/ cervical carcinoma)
- Dx in teens and young adults
- Clinically present as multiple (!) sessile papules or plaques w/ a cauliflower-like surface

Front 8

Condyloma Acuminatum Histo

Back 8

- Papillary epithelial proliferation w/ broad, blunted fronds
- Abundant mitoses; koilocytosis
- Molecular evidence of HPV

Front 9

Condyloma Acuminatum Tx

Back 9

- Excision, cryotherapy, laser excision
- Recurrence is common- 30% of patients have recurrent lesions after Tx

Front 10

Seborrheic Keratosis

Back 10

- Very common benign cutaneous lesion of epidermal origin
- Usually seen on the face, trunk, or extremities- areas w/ numerous sebaceous glands
- Tendency to develop these lesions after 40 yrs of age, although may be seen earlier
- Sharply demarcated, slightly raised plaques
- Range in color from tan, brown, to black; homogenous
- Have "stuck-on" experience

Front 11

Seborrheic Keratosis Histo

Back 11

- Composed of basaloid epidermal cells
- Variable amounts of papillomatosis and keratin formation
- Horncysts and pseudohorncysts are common

Front 12

Dermatosis Papulosa Nigra

Back 12

- Affects 35% of African Americans
- Onset during adolescence
- Appear as small, smooth, dark papules located on the face, particularly in the malar region
- Histopath, small seborrheic keratoses
- No Tx needed

Front 13

Sebaceous Hyperplasia

Back 13

- Relatively common benign process
- Most often occurs on the facial skin of middle-aged or older adults
- May be solitary or multiple
- 1-5 mm umbilicated yellowish papule
- May be mistaken for basal cell carcinoma
- Squeeze lesion to see if sebum comes out for differential diagnosis

Front 14

Sebaceous Hyperplasia Histo

Back 14

- Multiple hyperplastic lobules of sebaceous gland
- Ducts empty into the central depressed area of the lesion

Front 15

Sebaceous Hyperplasia Tx

Back 15

- None necessary
- Simple surgical excision for cosmetic purposes or to rule out basal cell carcinoma
- Prognosis: excellent

Front 16

Nicotine Stomatitis

Back 16

- Diffuse white, appearance to the palatal mucous; surface may be wrinkly or fissured
- Elevated papules w/ punctate red centers (represent inflamed minor salivary gland orifices)
- Assoc. w/ smoking
- A response to heat generated, rather than chemicals in the tobacco smoke (chronic hot drinking beverages can do the same)
- Dx: clinically diagnostic

Front 17

Nicotine Stomatitis Tx and Prognosis

Back 17

- Tx: None needed, but patient should be encourage to quit smoking
- Prognosis: Not precancerous
- Should resolve w/in 1-2 weeks of smoking cessation