Describing oral lesions

‘A bright red, velvety plaque that cannot be characterised clinically or pathologically as any other recognisable condition

Erythroplakia

Clinical term, no specific histology

Leukoplakia

Mixed lesion - leukoplakia with red patches/areas of erythroplakia. High risk lesion

Speckled leukoplakia

White → due to epithelial thickening, various forms

Keratosis

Thinning of the epithelium, associated with areas of erosion/ulceration

Atrophy

‘Partial loss of surface epithelium without underlying exposure of deep layers or connective tissue

Erosion

‘Complete loss of epithelium with exposure of the underlying connective tissue’

Ulcer

A larger blister >5mm

Bulla

A small blister <5mm

Vesicle

‘A circumscribed flat area of discoloration <10mm diameter’, non palpable

Macule

‘A circumscribed, flat area of discolouration >10mm diameter’ Non-palpable

Patch

Broad based

Sessile

Attached by a stalk

Pedunculated

Lesion with multiple finger-like projections

Papillomatous

Where is the lesion in the mouth?

Site

Size (L&W) or diameter (in mm), what does it look like?

Size and shape

Single or multiple? Localised or generalised?

Distribution

Flat/raised?

Does all/part of the lesion wipe off?

Contact bleeding?

Smooth/rough/papillary/crusted/corrugated/fissured?

Texture

Soft? Hard? Indurated? Fluctuant?

Consistency

Are the margins well-circumscribed or poorly circumscribed?

Outline

Is it erythroplakia, leukoplakia or other?

Colour of lesion

Keratotic halo

Slough