Erosive Lichen Planus Diagnosis and Treatment
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Questions and Answers

What is the primary reason for performing a biopsy in erosive lichen planus?

  • To identify the underlying cause of the ulcer
  • To rule out neoplasm (correct)
  • To assess the effectiveness of treatment
  • To confirm the diagnosis of erosive lichen planus

    • What is the typical timeframe for the development of chemotherapy-related ulceration?

  • Within 1-2 years
  • Within 1-2 weeks (correct)
  • Within 1-2 days
  • Within 1-2 months

    • What is the primary goal of treatment for chronic oral ulcers?

  • To refer the patient to a specialist
  • To perform a biopsy
  • To eliminate the underlying cause
  • To make the patient comfortable (correct)

    • Which of the following is a common feature of oral Crohn's disease?

    <p>It is often a solitary lesion</p> Signup and view all the answers

    What is the purpose of removing precipitating factors in erosive lichen planus?

    <p>To alleviate symptoms</p> Signup and view all the answers

    What is the primary concern in managing chemotherapy-related ulceration?

    <p>Managing nutrition and hydration</p> Signup and view all the answers

    What is the role of a dentist in managing oral Crohn's disease?

    <p>To provide supportive care and refer the patient to a specialist</p> Signup and view all the answers

    What is the typical outcome of chemotherapy-related ulceration after chemotherapy is completed?

    <p>The ulceration resolves</p> Signup and view all the answers

    What is the primary cause of Focal/Frictional Hyperkeratosis?

    <p>Chronic irritation at a specific site</p> Signup and view all the answers

    In which individuals is Oral Hairy Leukoplakia commonly seen?

    <p>Immune-suppressed individuals</p> Signup and view all the answers

    What is the characteristic appearance of Nicotinic Stomatitis?

    <p>Red dots on the palate with surrounding white keratotic rings</p> Signup and view all the answers

    What is a characteristic of a submucosal hemorrhage?

    <p>Does not blanch with pressure</p> Signup and view all the answers

    What is a treatment option for Hemangioma and Vascular Malformation?

    <p>Laser</p> Signup and view all the answers

    What is the primary goal of the biopsy in Oral Hairy Leukoplakia?

    <p>To diagnose Epstein-Barr Virus infection</p> Signup and view all the answers

    What is a complication of Vascular Malformation of the Jaws?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment for Nicotinic Stomatitis?

    <p>Tobacco/smoking cessation and continued observation</p> Signup and view all the answers

    What is the characteristic of Idiopathic Leukoplakia?

    <p>No identifiable cause or underlying factor</p> Signup and view all the answers

    What is the purpose of aspirating before incision in a Vascular Malformation of the Jaws?

    <p>To assess the vascularity of the lesion</p> Signup and view all the answers

    What is used to image Vascular Malformations?

    <p>Conventional angiography and Magnetic Resonance Angiogram (MRA)</p> Signup and view all the answers

    What is the treatment for Focal/Frictional Hyperkeratosis?

    <p>Remove the underlying cause/irritation</p> Signup and view all the answers

    What is a sclerosing agent used to treat Vascular Malformations?

    <p>All of the above</p> Signup and view all the answers

    What is the common location of Oral Hairy Leukoplakia?

    <p>Lateral border of the tongue</p> Signup and view all the answers

    What is the primary cause of Physiologic Pigmentation in darker skinned individuals?

    <p>Normal variation in melanin production</p> Signup and view all the answers

    Which of the following is a characteristic of Classic KS?

    <p>Milder and with few issues</p> Signup and view all the answers

    What is the main treatment for Smoker's Melanosis?

    <p>Smoking cessation</p> Signup and view all the answers

    Which of the following drugs is NOT associated with Drug-Induced Pigmentation?

    <p>Aspirin</p> Signup and view all the answers

    What is the primary mechanism of Drug-Induced Pigmentation?

    <p>Stimulation of melanin production</p> Signup and view all the answers

    What is the preferred type of retainer in prosthetic management for Sjögren's syndrome?

    <p>Non-tissue bearing full coverage retainer</p> Signup and view all the answers

    Which of the following heavy metals is associated with Heavy Metal Staining?

    <p>Gold</p> Signup and view all the answers

    What is the primary treatment for Post-Inflammatory/Reactive Pigmentation?

    <p>Treatment of the underlying mucocutaneous disorder</p> Signup and view all the answers

    What is a common oral complication associated with Sjögren's syndrome?

    <p>Dysgeusia</p> Signup and view all the answers

    What is the primary goal of dietary counseling in managing Sjögren's syndrome?

    <p>To stimulate salivary flow</p> Signup and view all the answers

    What is the mechanism of action of pilocarpine (Salagen®) in stimulating salivary flow?

    <p>Cholinergic agonist</p> Signup and view all the answers

    What is the characteristic of Post-Inflammatory/Reactive Pigmentation?

    <p>Increased melanin production and deposition due to trauma or inflammation</p> Signup and view all the answers

    What is the common characteristic of symptoms experienced by patients with burning mouth syndrome?

    <p>Burning, scaly, hot, and prickly</p> Signup and view all the answers

    What is the primary component of oral lubricants used in managing Sjögren's syndrome?

    <p>Glycerin</p> Signup and view all the answers

    What is the purpose of fluoride trays in managing Sjögren's syndrome?

    <p>To remineralize tooth enamel</p> Signup and view all the answers

    What is the common feature of oral hygiene products that can exacerbate Sjögren's syndrome?

    <p>Eugenol content</p> Signup and view all the answers

    Study Notes

    Erosive Lichen Planus

    • Biopsy is necessary to confirm diagnosis
    • May transform into neoplasm if left untreated
    • Removal of precipitating factors such as food, mouth care products, medications, and stresses is crucial
    • Palliative care may be necessary for chronic lesions, and topical steroids may be considered

    Oral Crohn's Disease

    • Consult with MD, as it may be the first presentation
    • Eliminate aggravating factors such as diet
    • Treatment may be directed by the GI or rheumatology specialist, with support from DDS
    • Affects rapidly dividing cells in the mucosa, leading to ulceration within 1-2 weeks
    • Superinfection may occur due to immune compromise
    • Palliative care is necessary, including hydration, vitamin supplementation, and oral mouth rinse (Tantum)
    • Ulcerations usually resolve after chemotherapy is complete

    General Approach to Ulcers

    • Duration and previous incidence should be considered
    • Remove suspected causes and make patients comfortable
    • Close monitoring and follow-up are necessary
    • Biopsy and referral may be necessary

    Chronic Oral Ulcers

    • Categories of ulcers include acute (single or multiple) and chronic (single or multiple)
    • Focal/Frictional Hyperkeratosis occurs due to trauma, leading to increased keratin production
    • Treatment involves removing the underlying cause or irritation

    Oral Hairy Leukoplakia

    • Caused by Epstein-Barr Virus infection in immune-suppressed individuals
    • Seen on the lateral border of the tongue
    • Diagnosis involves biopsy, and treatment includes antiviral meds and excision for limited areas

    Nicotinic Stomatitis

    • Caused by tobacco smoking, particularly pipe smoking
    • Characterized by red dots on the palate with surrounding white keratotic rings (halo)
    • Treatment involves tobacco cessation, and biopsy if no resolution

    Idiopathic Leukoplakia

    • Characterized by white patches due to chronic irritation from substances like EtOH, tobacco, and HPV
    • Treatment involves removing the source of irritation and close observation

    Hemangioma vs. Vascular Malformation

    • Vascular malformation is limited in extent and easier to manage
    • Treatment options include laser, resection, and magnetic resonance angiogram (MRA)
    • Hemangioma of the jaws can be life-threatening and requires high caution

    Submucosal Hemorrhage

    • Characterized by well-demarcated, red to red-brown to pale brown lesions
    • Caused by trauma, pressure, surgery, and coughing
    • Seen in anticoagulated patients and those with underlying medical conditions

    Physiologic Pigmentation

    • Seen in darker-skinned individuals
    • Characterized by diffuse brownish epithelial pigmentation in the gingiva and buccal mucosa
    • No treatment is necessary

    Post-Inflammatory/Reactive Pigmentation

    • Seen in susceptible individuals due to trauma or inflammation
    • Characterized by increased melanin production and deposition
    • Resolution occurs once the trigger is removed

    Smoker's Melanosis

    • Characterized by diffuse hyperpigmentation due to prolonged tobacco use
    • Treatment involves smoking cessation, but may not guarantee resolution

    Drug-Induced Pigmentation

    • Characterized by diffuse mucosal and/or cutaneous pigmentation
    • Caused by chronic drug use, stimulating melanin production
    • Treatment involves stopping the causative drug

    Heavy Metal Staining

    • Characterized by deposition of heavy metals like lead, mercury, and gold
    • Biopsy can show lymphocytic infiltrate in the case of Sjögren's
    • Treatment involves removing the source of heavy metal exposure

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    Description

    This quiz covers the diagnosis and treatment of erosive lichen planus, including biopsy confirmation, removal of precipitating factors, and palliative care. It also touches on the potential for transformation into neoplasms, such as squamous cell carcinoma.

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