Dental Pathology Lecture Notes: Red, White, Purple, and Pigmented Lesions

Compendium of vocabulary terms from lecture notes covering red, purple, white, and pigmented oral lesions, including reactive, inflammatory, and neoplastic conditions.

Pyogenic Granuloma

A benign vascular growth representing an exuberant response of tissue to trauma or irritation; often called a pregnancy tumor, pregnancy granuloma, epulis gravidarum, or puberty granuloma.

Peripheral Giant Cell Granuloma (PGCG)

A localized reactive hyperplastic response to injury characterized by a deep red or bluish color and the presence of giant cells and fibroblasts; usually found on the gingiva or edentulous ridges.

Petechia

Pinpoint sized ($1-2\,mm$) hemorrhages that do not blanch with diascopy, often caused by trauma or systemic blood disorders like Leukemia.

Purpura

Hemorrhages larger than petechia ($>2\,mm$) caused by trauma or systemic diseases; they do not blanch with diascopy.

Ecchymoses

The largest of the three hemorrhages ($>2\,mm$), commonly arising from trauma (biting, eating disorders) or iatrogenic causes, which does not blanch with diascopy.

Lichen Planus

A chronic immune system disorder of unknown etiology that can affect oral, genital, and skin areas; types include reticular, plaque, atrophic, bullous, and erosive forms.

The Four P’s of Lichen Planus

Cutaneous characteristics of Lichen Planus: Purple (color), Pruritic (itchy), Polygonal (shape), and Plaques (raised/crusted lesions).

Erosive Lichen Planus

The most aggressive form of Lichen Planus, characterized by ulcerative stripping of the epithelium and a higher risk of transformation to Squamous Cell Carcinoma (SCC).

Candidiasis (Candidosis)

The most common fungal infection, commonly known as "thrush," characterized by raw, red surfaces when lesions are wiped off.

Angular Cheilitis (Perleche)

A fungal infection occurring at the commissure of the mouth, often associated with saliva collection in older individuals or those with diabetes.

Median Rhomboid Glossitis

A rhombus-shaped area of central denuded papillae on the tongue linked to C. albicans, often associated with smokers and denture wearers.

Erythroplakia (Erythroplasia)

A velvety red patch that is considered premalignant, with at least $85\%$ being severely dysplastic upon biopsy.

Lingual Varicosities

Abnormally dilated or tortuous veins found under the tongue, primarily in older adults, with the main concern being thrombosis.

Hematoma

An area of blood pooled under the skin, often called a "blood blister," where diascopy reveals no disruption of blood supply.

Congenital Hemangioma

A benign proliferation of blood vessels composed of capillaries and venules that blanches with pressure (diascopy) and often resolves on its own.

Lymphangioma

A lesion of lymphatic vessels present at birth (embryogenesis) that does not involute and may be found on the tongue, buccal mucosa, or floor of the mouth.

Hereditary Hemorrhagic Telangiectasia

Also known as Osler-Weber-Rendu Disease, an autosomal dominant condition characterized by dilated spider veins on the lips and tongue that may bleed profusely.

Fordyce Granules

Normal, ectopic sebaceous glands evident in $80\%$ of the population, appearing as asymptomatic yellow-white spots on the buccal mucosa or lower lip.

Leukoedema

A variation of normal oral mucosa that is more common in African Americans and disappears when the tissue is stretched.

Geographic Tongue

Also known as Erythema Migrans, it presents as atrophic patches with yellow or white concentric rings and involves the depapillation of filiform papillae.

Frictional Keratosis

A whitish plaque formed as an adaptive response (callus) to physical irritation.

Linea Alba

A specific type of localized frictional keratosis that occurs along the occlusal line of the buccal mucosa, often indicating bruxism.

Nicotine Stomatitis

White keratinized tissue on the palate of heavy smokers where the minor salivary gland duct openings appear as red dots.

Hairy Tongue

The elongation of filiform papillae on the dorsal tongue, which may appear white or brown, often caused by antibiotics, smoking, or radiation therapy.

Coagulation Necrosis

Necrosis of the surface epithelium resulting from a chemical burn, where cells within the epithelium no longer have a nuclei.

Pseudomembranous Candidiasis

A fungal infection appearing as white plaques that RUB OFF, typically found in immunocompromised or xerostomic patients.

Chronic Hyperplastic Candidiasis

The only form of Candidiasis with malignant potential and considered premalignant; it WILL NOT wipe off.

Hairy Leukoplakia

A white lesion caused by the Epstein-Barr Virus (EBV) secondary to immunosuppression (HIV/AIDS) that does not rub off.

Parulis

A swelling of the gingiva containing yellow pus (purulent exudate) representing the drainage of a sinus tract from an odontogenic infection.

Wickham Striae

The white, latus-work pathogmonic pattern often seen in the reticular form of Lichen Planus.

White Sponge Nevus

A rare, inherited autosomal dominant condition caused by a mutation of keratin genes, presenting as widespread white keratinization of the buccal mucosa.

Leukoplakia

A white patch that does not rub off and cannot be diagnosed clinically or pathologically as any specific disease; it is considered a premalignant state.

Oral Submucous Fibrosis (OSF)

A premalignant condition caused by Areca nut chewing, where arecoline triggers collagen production by fibroblasts, creating thick bands that inhibit mouth opening.

Amalgam Tattoo (Focal Argyrosis)

Gray, blue, or black pigmentation caused by amalgam fragments being forced into the tissues during restorative or endodontic work.

Burtonian Line

A lead-line stain (blue, gray, or black) in the premolar region of the gum tissue, signifying lead poisoning (Plumbism).

Oral Melanotic Macule (Focal Melanosis)

A flat, brown, benign lesion most commonly found on the lip, affecting $3\%$ of the population.

Solar Lentigo

Permanent "age spots" or sun damage seen in adults that persist indefinitely regardless of sun protection.

Oral Squamous Papilloma

An oral wart capable of transmitting HPV, appearing as a raised lesion with a rough or papillary surface.

Verruca Vulgaris

Commonly known as the common wart, caused by low-risk HPV types ($1$, $2$, $4$, $26$, $27$, $40$, and $41$).

Condyloma Acuminatum

Genital or venereal warts transmitted by direct oral-oral or oral-genital contact.

Focal Epithelial Hyperplasia (Heck Disease)

A condition caused by low-risk HPV $13$ & $32$, producing pink to whitish translucent lesions with a cauliflower-like surface.

Verrucous Carcinoma

Often termed "snuff dippers’ cancer," this malignancy is primarily related to the use of spit tobacco (snuff or chewing tobacco).