MIDTERMS1 Lesson 6: White Lesions and Papilloma

Hereditary Conditions, Reactive Lesions, Preneoplastic and Neoplastic Lesions, Other White Lesions, Nonepithelial White-Yellow Lesions

White Lesions (5)(HRPON)(Hc Rl Panl, Owl, Nw-yl)

Leukoedema, White Sponge Nevus, Hereditary Benign Intraepithelial Dyskeratosis, Follicular Keratosis

4 Hereditary Conditions (L, Wsn, Hbid, Fk) (LWHF)

Leukoedema

generalized mild opacification of the buccal mucosa

• variation of normal

• possible association w/ irritation

unknown

etiology of Leukoedema

Leukoedema

clinical features of ______:

• NO GENDER predilection

• Children, Adults

• African-Americans

• Affected site: Buccal Mucosa > Labial Mucosa (Bilateral)

• Asymptomatic

• Gray-white, diffuse, filmy, or milky surface alteration

• exaggerated cases: Whitish cast w/ surface textural changes, including wrinkling or corrugation

Leukoedema

DIAGNOSTIC FEATURE OF _______: it disappears when stretched

Epithelium is parakeratotic and acanthotic with marked intracellular edema of spinous cells

HISTOPATH OF LEUKOEDEMA:

“Epithelium is __________ paawmieosc”

White sponge Nevus, Lichen Planus, Leukoplakia, Hereditary Benign Intraepithelial Dyskeratosis, Frictional Keratosis

DIfferential Diagnosis of Leukoedema (5)(W L L H F)(Wsn Lp L Hbid Fk)

no treatment

treatment for Leukoedema?

true

true or false?
for Leukoedema changes are innocuous (not harmful) and there is NO malignant potential

White Sponge Nevus

autosomal dominant inherited condition

Cannon’s Disease, Familial Epithelial Hyperplasia

White Sponge Nevus is aka C______ and F____ ____

Keratin 4 and/or 13

White Sponge Nevus occurs due to mutations in _______

Keratin 4 and/or 13

_____ are proteins that is essential for structural integrity and resilience of mucosal tissues

White Sponge Nevus

Clinical Features of _________

• NO GENDER predilection

• early in life, before puberty

• Affected site 3(BTV): Buccal mucosa, Tongue, Vestibular mucosa

• Bilateral and Symmetric, folded, white lesion that may affect several mucosal sites

• Mucosa appears thickened with a soft or spongy texture and peculiar pearly white or gray hue

• asymptomatic

• extraoral involvement (NRG) (Nose, Rectum, Genitals)

Buccal mucosa, Tongue, Vestibular mucosa

affected site of White Sponge Nevus (3)(BTV)

White Sponge Nevus

Bilateral and symmetric, folded, white lesion that may affect several mucosal sites

White Sponge Nevus

in ______ the mucosa appears thickened with a soft or spongy texture and peculiar pearly white or gray hue

White Sponge Nevus

DIAGNOSTIC FEATURE OF _______: it DOES NOT disappear when cheek is stretched

Epithelium is greatly thickened (marked spongiosis, acanthosis, parakeratosis), Perinuclear eosinophilic condensation of cytoplasm (prickle cells)

Histopath of White Sponge Nevus (2)[eigt(msap), pecoc(pc)]

Spongiosis

pattern of widened spaces between keratinocytes due to increased tissue fluid or intercellular edema

Hereditary Benign Intraepithelial Dyskeratosis, Lichen Planus, Lichenoid Drug reaction, Lupus Erythematosus, Cheek chewing, Candidiasis

6 Differential Diagnosis of White Sponge Nevus (Hbid, L L L , C C)

Candidiasis

• aka Thrush

Candida albicans

Candidiasis is caused by _______

Candidiasis

white patchy lesion that can be rubbed or scraped off

No treatment

Treatment for White Sponge Nevus

Low

White Sponge Nevus has _____ malignant potential

Hereditary Benign Intraepithelial Dyskeratosis

a RARE autosomal dominant hereditary condition

Hereditary Benign Intraepithelial Dyskeratosis, white, Indian, African American

______ is noted within a tri-racial isolate of _____, _____, and ____ ____ (WIAf)

Witkop Disease, Witkop-von Sallmann Syndrome

Hereditary Benign Intraepithelial Dyskeratosis is aka ______ or ________