Oral Pathology Week 10 Ppt - Skin Lesions

Front 1

What are the 3 statistics about skin lesions?

Back 1

•AAD in 2012, stated more than 3.5 million skin cancers are diagnosed annually.

•Nationally there are more new cases of skin cancer each year than breast, prostate, lung, and colon cancer combined.

•Skin cancer is the number 1 cancer seen in men over the age of 50 and has tripled in women under the age of 40.

Front 2

What are the 8 risk factors for developing skin lesions?

Back 2

• Tobacco use

• Heavy alcohol use

• Physical inactivity

• Poor diet

• Unprotected sun exposure including tanning beds

• Exposure to carcinogens

• Light skinned

• Blue or green eyes

Front 3

Name This Lesion:

•Malignant neoplasm of melanoctyic origin.

•Damage from UV radiation primary causative factor

•3rd most common skin cancer but only 5% of total skin cancers.

•Every 10 minutes someone in the US is diagnosed with this lesion and one dies every hour.

•Its rate is 1 in 50 Americans.

•It is the most common cancer in women age 20-29 years.

•Second only to breast cancer in women 30-35

•One blistering sunburn in childhood greatly increases a person’s chance of developing skin cancer

•Starting to see a correlation to tanning bed use especially in young women and girls

Back 3

Melanoma

Front 4

What are the 6 facts about tanning beds?

Back 4

•They emit as much as 15 times stronger UVA and UVB than sun exposure

•Increases the chance of melanoma

•Are often unregulated

•Bulbs in devices are often not regulated

•Protective glasses are not always used

•Children as young as 10-11 years areallowed in many

Front 5

Name This Lesion:

•Most common skin cancer—80% of all skin cancers

•Locally invasive, slow spreading

•Often found in areas of chronic UV exposure

•More common in people having sunburns as children

•Non-healing sore, pink with rolled, elevated borders or waxy texture

•Often appear in upper 2/3 of face including eye area

Back 5

Basal Cell Carcinoma

Front 6

Name This Lesion:

–Firm, painless papule that slowly enlarges and gradually develops a central depression. May develop a telangiectac blood vessel over border

Back 6

Nodular Form of Basal Cell Carcinoma

Front 7

Name This Lesion:

–Seen occasionally, colonized by benign melanocytes and will be tan, brown, black or bluish in color

Back 7

Pigmented Form of Basal Cell Carcinoma

Front 8

Name This Lesion:

–Often mimics scar tissue-overlying tissue appears pale and atrophic. Lesion is firm to palpation with poorly demarcated borders

Back 8

Sclerosing Form of Basal Cell Carcinoma

Front 9

NameThis Lesion:

–Occurs primarily on the skin of thetrunk. Often lesions are multiple and appear well-demarcated, erythematous,scaly patches often mistaken for psoriasis.

Back 9

Superficial Form of Basal Cell Carcinoma

Front 10

Name This Lesion:

•Often have a roughened, scaly appearance and may appear ulcerated as they progress

•Sun-exposed areas most vulnerable

•Lower lip is prime area because of the angle to the sun.

•Fair skin with blue or green eyes are at increased risk

•Biopsy to diagnose

•Surgical removal and radiation therapy to treat

Back 10

Squamous Cell Carcinoma

Front 11

Name This Lesion:

•Most common type of pre-cancerous skin lesion

•Scaly or crusty patches

•Most commonly found on backs of hands, cheek, ear, forehead and lower lip

•Lesions develop slowly

•Treatment may be removal, laser surgery, topical medication.

Back 11

Actinic Keratosis

Or

Solar Keratosis

Front 12

Name This Lesion:

•Form of actinic keratosis that develops on the lips and may evolve into a type of squamous cell carcinoma

•Lips appear scaly and crusted with loss of definition of vermillion border

•Refer to dermatologist for evaluation

•Recommend sunscreen

Back 12

Actinic Cheilitis

Front 13

NameThis Lesion:

•Skin tag

•May be pedunculated

•Usually small, slender stalks of tissue

•Usually flesh colored

•Monitor for changes

Back 13

Acrochordon

Front 14

Name This Lesion:

•Dilated hair follicles filled with keratin, bacteria, and sebum.

•Open lesions become trapped with blackened mass of epithelial debris.

•Exposure to the sun and elements is common.

•Appear similar to acne but without inflammation

•Refer to dermatologist

•Vitamin A acid, Retin A to treat

Back 14

Comedones

Front 15

Name This Lesion:

•General term for an inflammatory response of the skin to multiple agents

•Often associated with hypersensitivity type 1 reactions.

•May be due to occupational exposure

•Symptoms include dryness, pruritus, and inflammation

•Topical steroids to treat or may resolve on its own

Back 15

Eczema

Front 16

Name This Lesion:

•Hyperplastic scar tissue

•More common in African Americans

Back 16

Keloid Scar

Front 17

Name This Lesion:

•Benign macules caused by sun exposure

•Usually larger than freckles

•Fade more easily when sun exposure is diminished

•When they occur peri-orally, other disorders or syndromes should be considered such as Peutz-Jeghers syndrome or Addison’s disease

•Also called liver spots or age spots.

Back 17

Solar Lentigo

Front 18

NameThis Lesion:

•Small sub-epidermal keratinous cysts

•Develop on eyelid or face

•May be removed for cosmetic reasons or dissolve on their own

Back 18

Milia (plural of milium)

Or

Epidermal Inclusion Cysts

Front 19

Name This Lesion:

•Acquired melanocytic lesion

•Visible on face, neck when performing EO

•Collection of nevus cells in the dermis or epithelium

•Junctional or compound

•Usually have a smooth surface, sometimes pebbled, and be flesh colored or pigmented ranging in size from 0.1 to 0.6 mm.

•Usually begin in childhood and increase in adulthood

•Mapping or photography help in monitoring changes

Back 19

Nevi

Or

Moles

Front 20

Name This Lesion:

•Affects 2.6% of the population in the US

•Classic appearance of red, plaque-like lesions covered with a white thin scale that has a pearly, iridescent characteristic surrounding the lesions.

•Often episodic with periods of increased severity.

•Itching is common

•Corticosteroids to treat or light therapy

Back 20

Psoriasis

Front 21

Name This Lesion:

•Seen on the nose

•Sebaceous glands are enlarged and appear swollen with increased fibrosis and vascularity

•Seen more in males

•Called “hammer nose”

•Enlarged capillaries may be present

Back 21

Rhinophyma

Front 22

Name This Lesion:

•Typically seen on the nose and cheek areas.

•Seen as redness with chronic vascular and follicular dilation

•Sebaceous glands may be hyperplastic and pustules may be erythematous

•Characteristic of some systemic diseases such as lupus which is seen as a butterfly shaped rash in the malar region.

Back 22

Rosacea

Front 23

Name This Lesion:

•Vary from light brown to black and may be multiple or single lesions.

•Often appear in middle age and increase with age

•May be confused with warts

•Over-production of sebum of the sebaceous glands causing over-production of the horny layer of the skin

•Do not require treatment but can be removed with cryotherapy or curettage.

•Once removed, they usually do not return.

Back 23

Seborrheic Keratoses

Front 24

Name This Lesion:

•Also known as hives or allergic reactions.

•Can be a reaction to substances, sun,excitement or a systemic disease.

•Edema produces the wheal or plaque.

•May be single or coalesced.

•Treated with antihistamines,epinephrine, corticosteroids and identification of the offending substance.

Back 24

Urticaria

Front 25

Name This Lesion:

•Lesions are benign and only removed for cosmetic reasons

•Predominately lipid material and have been associated with hyper-lipidemia and low-density lipoproteins.

•Flat, yellow to orange plaques

Back 25

Xanthelasma

Front 26

What are the 9 diseases associated with skin lesions?

Back 26

•Erythema multiforme

•Graft versus Host Disease

•Impetigo

•Lichen Planus

•Lupus erythematosus

•Sarcoidosis

•Scleroderma

•Vitiligo

•Warts

Front 27

Name This Lesion:

•Iris lesion, target lesion, bull’s eye

•May be caused by HSV, mycoplasma, TB, histoplasmosis, and medications

Back 27

Erythema Multiforme

Front 28

Name This Lesion:

•Primarily associated with bone marrow transplants but may follow solid organ transplantation.

•Grafted bone marrow recognizes the tissues of the host as foreign and attacks them.

•Occurs in up to 45% of bone marrow patients

•Oral cavity is involved 80% of the time.

Back 28

Graft Versus Host Disease

Front 29

Name This Lesion:

•Highly contagious infection caused by Staphyloccus aureus and streptococci

•Most common pediatric skin infection usually starting in a traumatized area

•Erythematous papule that becomes pustular and ruptures with a yellow, crusted appearance

•Lesions may also be bulbous.

•Topical and systemic antibiotics to treat

•Postpone dental treatment due to its contagious nature and the ability to spread to other parts of the face and body.

Back 29

Impetigo

Front 30

Name This Lesion:

•Specific type of lesion of the lips

•May be oral or cutaneous

•Polygonal, purple, pruritic, plaques

•May affect any lining mucosa including the vagina and esophagus

Back 30

Lichen Planus

Front 31

Name This Lesion:

•Autoimmune disease

•Can affect multiple systems and vital organs

•Can cause ulcers and erosive lesions

•Can be seen sometimes as a butterfly rash

•Skin and scalp may be involved

Back 31

Lupus Erythematosus

Front 32

Name This Lesion:

•Granulomatous disease of unknown cause often affecting African Americans

•Systemic disease affecting multiple organs

•Salivary gland enlargement is often first characteristic that is noticed and xerostomia is commonly reported by patients.

Back 32

Sarcoidosis

Front 33

Name This Lesion:

•Immune dysfunction disease

•Generalized form

•Diffuse cutaneous form

•Both manifest with progressive thickening and tightening of the skin in all areas.

•Reynaud’s phenomenon is found in conjuction with the disease and is characterized by numbness and pallor offingers, toes, and nose due to intermittent lack of blood flow.

•Picture is of sclerodactyly which is thickening or hardening of the skin.

Back 33

Scleroderma

Front 34

Name This Lesion:

•Autoimmune disorder characterized by lighter appearance of the tissue due to loss of pigment and destruction of melanocytes.

•Involves 1% of the world population

•Cause is unknown but exposure to chemicals is suspected

•Usually seen beginning second decade of life.

Back 34

Vitiligo

Front 35

Name This Lesion:

What are the 7 signs of Skin Cancer?

Back 35

•Asymmetry

•Border irregularity

•Color varied

•Diameter greater than 6mm

•Evolving: A noted change in any skinlesion

•A mole or lesion that does not heal

•Bleeding within or around a mole or anygrowth