ORAL PATHOLOGY: WHITE LESIONS [2]

LEUKOPLAKIA 

CLINICAL FEATURES:

• more common in men 

• most frequently involved

HISTOLOGICAL FEATURES:

• hyperorthokeratosis - thick stratum corneum

• acanthosis - thick stratum spinosum

• carcinoma in situ - entire thickness of epithelium affected

ETIOLOGY:

• tobacco 

• alcohol 

• vitamin deficiency (a and b)

TREATMENT:

• vitamin A and B complex

• x-ray therapy

• topical chemotherapy

LEUKOEDEMA

CLINICAL FEATURES:

• location of the lesion 

• stages of the lesion

HISTOLOGICAL FEATURES:

• increased thickness of epithelium

ETIOLOGY: 

• unknown

CLINICAL SIGNIFICANCE:

• px w/ leukoplakia also show signs of leukoedema in adjacent mucosa 

TREATMENT: 

• none

LICHEN PLANUS / LICHEN RUBER PLANUS

CLINICAL FEATURES: 

• primary symptom: severe pruritus 

• adulthood

• no sex predilection

HISTOLOGIC FEATURES 

• rete pegs with saw tooth appearance

ORAL MANIFESTATIONS:

• females

• 40-70yo

• lesser extent on: lips, palate, and tongue

ETIOLOGY:

• unknown 

DIFFERENTIAL DIAGNOSIS:

• syphilis

• leukoplakia

TREATMENT AND PROGNOSIS:

• no specific

• avoid stress 

• prognosis: uncommon to regress 

LICHEN PLANUS

FORM OF LICHEN PLANUS 

RETICULAR

FORM OF LICHEN PLANUS 

BULLOUS

FORM OF LICHEN PLANUS

EROSIVE

FORM OF LICHEN PLANUS

ERYTHEMATOUS OR ATROPHIC

FORM OF LICHEN PLANUS ON BUCCAL MUCOSA

EROSIVE

WHITE SPONGE NEVUS

ORAL EPITHELIAL NEVUS

CANNON’S DISEASES

CLINICAL FEATURES:

• CONGENITAL

• CHEEKS, PALATE, GINGIVA, FOM

• ASYMPTOMATIC

HISTOLOGIC FEATURES:

• HYPERPARAKERATOSIS

TREATMENT AND PROGNOSIS:

• NO TREATMENT

• EXCELLENT PROGNOSIS

WHITE SPONGE NEVUS

NICOTINE STOMATITIS

PIPE SMOKER’S PALATE

CLINICAL FEATURES:

• INITIALLY MANIFESTED BY REDNESS AND INFLAMMATION OF PALATE

• SOON, PALATE DEVELOPS DIFFUSE, GRAYISH-WHITE, THICKENED WITH SMALL RED SPOT IN CENTER OF EACH NODULE

HISTOLOGIC FEATURES:

• HYPERKERATOSIS

ETIOLOGY:

• CIGARETTE

• PIPE SMOKING

TREATMENT AND PROGNOSIS:

• DISCONTINUE TOBACCO

• RARELY EVOLVES TO MALIGNANT

NICOTINE STOMATITIS

CANDIDIASIS 

MONILIASIS 

THRUSH

CLINICAL FEATURES/MAJOR CATEGORIES:

• MUCOCUTANEOUS 

• SYSTEMIC 

HISTOLOGICAL FEATURES:

• PRESENCE OF YEAST CELLS AND HYPHAE

TREATMENT:

• ANTIFUNGAL AGENTS 

• AMPOREACIN 

• ICONOZALE 

ACUTE PSEUDOMEMBRANOUS CANDIDASIS

ACUTE ATROPHIC ERYTHEMATOUS CANDIDIASIS

CHRONIC HYPERPLASTIC CANDIDIASIS OR

CHRONIC MUCOCUTAENOUS CANDIDASIS 

CHRONIC ATROPHIC CANDIDIASIS

FORDYCE’S DISEASE OR GRANULES

CLINICAL FEATURES:

• NO SEX PREDILECTION

• PALATE, GINGIVA, TONGUE, FRENUM, RETROMOLAR REGION

HISTOLOGICAL FEATURES:

• IDENTICAL WITH NORMAL SKIN BUT NOT ASSOC. WITH HAIR

ETIOLOGY:

• NO SEX PREDILECTION

• PALATE, GINGIVA, TONGUE, FRENUM, RETROMOLAR REGION

TREATMENT:

• NONE

FORDYCE’S DISEASE

GEOGRAPHIC TONGUE

BENIGN MIGRATORY GLOSSITIS

WANDERING RUSH OF TONGUE

CLINICAL FEATURES:

• MULTIPLE DESQUAMATION OF FILIFORM PAPILLAE

• FREQUENTLY ASSOC. WITH FISSURED TONGUE

HISTOLOGIC FEATURES:

• FILIFORM PAPILLAE ARE LOST

• FILIFORM PAPILLAE MARGINS EXHIBIT HYPERKERATOSIS AND ACANTHOSIS

ETIOLOGY:

• UNKNOWN (EMOTIONAL STRESS)

TREATMENT:

• EMPIRICAL

• BAKING SODA, ANTIFUNGALS

WHITE HAIRY TONGUE

CLINICAL FEATURES:

• COLOR OF PAPILLAE VARY FROM YELLOWISH WHITE/BLACK/BROWN

ETIOLOGY:

• UNKNOWN

TREATMENT:

• EMPIRICAL

• BAKING SODA

PERLECHE 

ANGULAR CHEILIITIS 

ANGULAR CHEILOSIS 

CLINICAL FEATURES:

• BOTH YOUNG CHILDREN AND ADULTS 

• DRYNESS AND BURNING SENSATION AT CORNERS OF MOUTH

ETIOLOGY:

• LIP SUCKING 

• SAGGING OF FACIAL SKIN 

TREATMENT:

• EMPIRICAL 

• LIP BALM