Oral Path - Red And Purple Lesions

Front 1

Traumatic or Inflammatory Lesions

Back 1

* Cause: Constant Forces, Trauma or Tissue Laceration
* Results: Chronic Inflammation or Exuberence of Tissue

Front 2

Traumatic or Inflammatory Lesions:
Pyogenic Granuloma

Back 2

* aka: Pregnancy Tumor

* Cause: exuberant tissue response to trauma or local irritation

* Characteristics: Bright red initially but changes over time. ranges from few mm to cm's.

* Location: Maxillary anterior gingiva, lower lip, tongue, and buccal mucosa.

* Treatment: Excise (surgical/laser) so it doesn't recur. Scale and rinse w/ chlorhexidine.

Front 3

Traumatic or Inflammatory Lesions:

Peripheral Giant Cell Granuloma

Back 3

* aka: Giant Cell Epulis

* Cause: Reactive hyperplastic response to tissue injury (tooth extraction, plaque, calculus, restorations or dentures) often in 50-60 yr olds.

* Location: Found on gingiva or edentulous ridge from 1-2 cm. Comes from periodontal ligament, or periosteum w/ occasional alveolar bone involvement.

* Treatment: Complete excision (lesion, periosteum and ligament), removal of irritant, scale and rootplan w/ frequent appointments/follow-ups exams

Front 4

Word Of The Day:

Diascopy

Back 4

* Technique for examining erythematous skin lesions.

* Press clear glass over lesion

--- blanching = vascular engorgement/inflammation

--- no blanching = hemorrhage in skin/non-vascular

Front 5

Traumatic or Inflammatory Lesions:

Petechiae

Back 5

* Cause: trauma or disease. May indicate blood dyscrasia.

* Characteristics: 1-2mm pinpoint hemorrhage. Will NOT blanch w/ pressure

* Location: cheek, tongue, palate, oropharangeal area, and lips

Front 6

Traumatic or Inflammatory Lesions:

Purpura

Back 6

* Cause: Trauma or disease. May indicate blood dyscrasia, or Rock Mountain Spotted Fever.

* Characteristics: >2mm Patch of hemorrhage. Will NOT blanch w/ pressure.

* Location: cheek, tongue, palate, oropharangeal area, and lips.

Front 7

Traumatic or Inflammatory Lesions:

Ecchymoses

Back 7

* Cause: Trauma or disease. May indicate Hemophilia-related disorder.

* Characteristics: >2cm Patch of hemorrhage. Will NOT blanch w/ pressure.

* Location: cheek, tongue, palate, oropharangeal area, and lips.

Front 8

Immune System Disorders: Lichen Planus

(4 P's)

Back 8

* Cause: Unknown; chronic, inflammatory mucocutaneous disease.

* Characteristics: Wickham's Stria (lacy white pattern). Can be red, white or purple. Itchy, keratotic, violaceous

* Location: buccal mucosa, tongue, gingiva, lips, floor, palate, and cutaneous tissue.

* 4 Ps: Purple, Pruretic, Polygonal, Plaques

* Forms: Reticular, Papular, Plaque, Atrophic, Bulbous or Erosive.

* Treatment: Topical corticosteroids. remove aggravating product. Document w/ Radiographs and tissue biopsy.

* ASSOCIATED W/ INCREASED MALIGNANCY!

* May require non amalgam/gold restorations

Front 9

Immune System Disorders: Lichenoid Reaction

Back 9

* Cause: Reaction to dental products such as amalgam/gold, toothpaste, flavoring agent, MSG, Cinnamon aldehyde or drugs.

* Delayed cell-mediated immune response

Front 10

Immune System Disorders: Mucosal Allergy

Back 10

* aka: Allergic Contact Stomatitis

* Cause: Reaction to food, flavoring agent, mouthrinses, toothpastes, cinnamon aldehyde or oil, and dental materials.

* Characteristics: Fiery red edematous tissue.

Front 11

Immune System Disorders: Plasma Cell Gingivitis

Back 11

* aka: Allergic gingivostomatitis

* Cause: Reaction to chewing gum, toothpaste or peppers.

Characteristics. Bright red, generalized enlargement of attached gingiva, angular cheilitis, fissured tongue with burning tongue and lips

Front 12

Infections: Candidosis/Candidiasis

Back 12

* Cause: Fungal Infection (candida abicans)

* Characteristics: Red or white, depending on location/predisposition factors. White wiped off w/ raw, red lesion underneath.

*Treatment: Nystatin and clotrimazole troches. Treat appliances/toothbrushes.

* Types: Erythematous: Acute atrophic, Chronic atrophic, Angular Cheilitis, and Median rhomboid glossitis.

Front 13

Infections: Erythematous Candida

Back 13

* Strong association w/ HIV infection.

* Characteristics: red erythematous tissue

Front 14

Infections: Acute Atrophic Candidiasis

Back 14

* Associated with broad-spectrum antibiotics

* Characteristics: Red tongue and burning sensations

Front 15

Infections: Chronic Atrophic Candidiasis

Back 15

* aka: Dneture Stomatitis

* Characteristics: Red edematous tissue beneath oral appliance.

Front 16

Infections: Angular Cheilitis - Candida

Back 16

* Characteristics: Red, ulcerated crevasses at commissure of mouth.

* Cause: dryness may cause area to crack, peal and appear ulcerated.

Front 17

Infections: Median Rhomboid Glossitis - Candida

Back 17

* Cause: Papillary Atrophy. Linked to C. Albicans

* Characteristics: Rhombus-shaped and central denuded papillae on tongue.

Front 18

Neoplasms:

Back 18

* aka: Tumors - Benign or malignant

* Benign - size varies. harmless unless they interfere w/ tissues or organs.

* Malignant - Potential to metastasize. Require surgical removal w/ possible radiation/chemotherapy

Front 19

Neoplasms: Kaposi's Sarcoma

Back 19

* Malignant

* Location: Skin, oral tissues and lymph nodes.

* Characteristics. Dark purple-black tissue. More common in debilitated patients (aids, elderly, HHV 8)

Front 20

Neoplasms: Erythroplakia - "Red Patch"

Back 20

* Considered Pre-Malignant.

* Associated with tobacco and alcohol use, dietary deficiencies, lifestyle factors, chronic friction/exposure to irritants.

* Characteristics: Velvety red or dark pink w/ varied surface textures.

* Brush biopsy or refer.

* Treatment: dependent on biopsy results - excise, radiation/chemo

Front 21

Varicosities

Back 21

* Abnormal dilated tortuous veins.

* Location: under tongue and on lower lip (venous varix)

*More visible in older adults. thrombosis is rare. No treatment needed.

Front 22

Hematoma

Back 22

* Cause: Usually trauma

* Characteristics: redish black - accumulation of blood in specific area.

* Diascopy - would not blanch.

Front 23

Hemangioma

Back 23

* Congenital: usually present at birth

* Benign proliferation of blood vessels.

* Location: Most common to lips and tongue, head and neck.

* May be capillary (small capillaries) or cavernous (larger blood vessels)

* Affects 2% of infants, mostly females.

Front 24

Lymphangioma

Back 24

* Vascular Malformations consisting of lymphatic vessels.

* Vary in size/location (tongue, buccal mucosa, floor of mouth)

* Present at birth - occur during embryogenesis

Front 25

Hereditary Hemorrhagic Telangiectasia

Back 25

* aka: Osler-Rendu-Weber Disease

* Genetic disease - begin early in life and increase w/ age.

* Characteristics: Telangiectasia (dilated blood vessels/spider veins/ small collections of dilated capillaries). Usually 1-3mm

* Can rupture and become ulcerated.