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27 Cards in this Set
- Front
- Back
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What is the definition of Leukoplakia? What are the consequences of this definition?
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White patch of the oral mucosa that cannot be scraped off and cannot be diagnosed clinically or microscopically as any other condition
Clinical term ONLY, not a diagnosis. Biopsy is mandatory. Considered a premalignant process |
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DDx for a white lesion...
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Leukoedema - goes away when skin stretched
Cheek chewing - narrow post, widens ant Frictional keratosis - corregated surface Nicotine stomatitis - post HP, raised nodules with red centre Snuff-dippers keratosis Aspirin burn Candidiasis Lichen planus - bilateral White Sponge Nevus Cinnamon reaction Leukoplakia |
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If a red component is present in a leukoplakia, what is it renamed?
What are the 3 surfaces leukoplakia can present with? |
Speckled leukoplakia
Smooth, verrucous, micronodular |
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What is the epideimiology for Leukoplakia?
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Older adult males, (>50 years), usually with hx of tobacco use.
Becoming more common in young males - marijuana? |
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What is the histology of Leukoplakia?
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Some degree of hyperkeratosis, precancerous changes (mild, mod or severe dysplasia or carcinoma-in-situ)
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What is the treatment for Leukoplakia?
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No or mild dysplasia - decrease carcinogenic habits, monitor
Moderate or worse, remove |
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What is the prognosis of Leukoplakia?
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15% of non-dysplastic lesions will transform if not treated
30% dysplastic lesions will transform 30% will recurr |
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What is a high risk presentation of Leukoplakia called?
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Proliferative Verrucous Leukoplakia
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What is Proliferative Verrucous Leukoplakia?
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An uncommon, high risk presentation of Leukoplakia, female predilection (4:1), only a third have traditional risk factors.
Females ave 65 years Males ave 49 years |
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What is the prognosis of Proliferative Verrucous Leukoplakia?
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70% develop SCC within a mean follow-up of 8 years
40% had died as a result of carcinoma |
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What is the definition of Erythroplakia?
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A red patch that cannot be diagnosed as any other condition clinically or microscopically.
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What does Erythroplakia look like and where is it usually found?
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velvety red, well demarcated patch, usually lateral tongue, FOM or soft palate
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What is the epidemeology of Erythroplakia?
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older males, carcincogenic risk factors
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What is the usually histological appearance of Erythroplakia?
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90% have severe epithelial dysplasia or worse at the time of biopsy.
Lack of keratin at surface = red appearance |
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What is the tx and prognosis?
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Similar to that for leukoplakia with similar degree of epithelial dysplasia
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What is Oral Submucous Fibrosis?
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Chronic progressive scarring disease of the oral mucosa, seen primarily in India and Southeast Asia.
Associated with the habit of betal nut chewing |
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What is betal nut?
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A combination of Areca nut, slaked lime, tobacco and spices wrapped in a betal leaf.
It is place in the buccal vestibule and the alkaloids from the nut are released and produce a mild euphoria. |
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How does Betel Nut cause Oral Submucous Fibrosis?
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The alkaloid form the nut stimulate collagen synthesis (in susceptible patients), resulting in the formation of fibrous bands affecting the oral mucosa.
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What is the result of Oral Submucous Fibrosis?
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Trismus, Uvual atrophy, hyperkeratosis with epithelial atrophy and atypia, leukoplakia
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What is the treatment for Oral Submucous Fibrosis?
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Discontinue betel nut habit.
Intralesional corticosteroids may improve mild cases of trismus, but in the long term cause more fibrosis. Severe cases may require surgical splitting of fibrous bands, with grafts and mouth props. All should be biopsied |
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What does biopsy usually show in Oral Submucous Fibrosis?
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10% show dysplasia at initial biopsy
Approximately 8% will undergo malignant transformation to SCC during a 10-year follow up period |
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What is Actinic Keratosis?
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A premalignant sun-induced skin lesion (scaly plaque with sandpaper texture) that is common on facial skin and vermilion zone of lips in fair skinned persons over 40 years of age. Caused by UV light exposure.
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What is the histology of Actinic Keratosis?
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Hyperkeratosis, usually parakeratin
Some degree of epithelial dysplasia or even superficially invasive SCC seen |
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What is the Treatment for Actinic Keratosis?
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Lesions tx with liquid nitrogen, surgical excision, laser ablation or 5-fluoro-uracil.
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What is the prognosis for Actinic Keratosis?
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Fair to good
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What is Actinic Cheilosis?
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Actinic keratosis involving the vermilion zone of the lower lip. Chronic scaling, crusting, ulceration and/or fissuring of the lip may be seen.
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What is the tx for Actinic Cheilosis?
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Vermilionectomy with advancement of the labial mucosa or laser ablation of the involved vermilion zone.
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