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Questions and Answers
Which of the following classifications corresponds to flat lesions?
Which of the following classifications corresponds to flat lesions?
- Vesicles
- Macules (correct)
- Erosions
- Pustules
In the management of Erythematous OLP, what is the suggested dosage method for systemic corticosteroids?
In the management of Erythematous OLP, what is the suggested dosage method for systemic corticosteroids?
- 1 mg/Kg daily for seven days, with a reduction of 5 mg each subsequent day.
- 1 mg/Kg daily for fourteen days, followed by a gradual taper.
- 1 mg/Kg daily for seven days, followed by a reduction of 10 mg each subsequent day. (correct)
- 2 mg/Kg daily for five days, with no tapering required.
What is a characteristic of lichenoid drug eruptions in relation to OLP?
What is a characteristic of lichenoid drug eruptions in relation to OLP?
- They always present as pustules on the skin.
- They mimic OLP both clinically and histologically. (correct)
- They cannot be resolved by stopping the offending drug.
- They only occur in patients with existing OLP.
Which of the following is a primary lesion defined as a superficial elevated solid lesion smaller than 1 cm?
Which of the following is a primary lesion defined as a superficial elevated solid lesion smaller than 1 cm?
What fluid is typically found in a bulla?
What fluid is typically found in a bulla?
Chronic lesions may lead to which of the following complications?
Chronic lesions may lead to which of the following complications?
In the context of herpes virus pathogenesis, what role do haptens play?
In the context of herpes virus pathogenesis, what role do haptens play?
In the viral growth cycle, which phase involves the virus attaching and entering the host cell?
In the viral growth cycle, which phase involves the virus attaching and entering the host cell?
What is a common predisposing factor for Candida Albicans tissue invasion?
What is a common predisposing factor for Candida Albicans tissue invasion?
Which form of candidiasis is primarily associated with the use of antibiotics?
Which form of candidiasis is primarily associated with the use of antibiotics?
Which clinical presentation helps distinguish erythematous candidiasis from erythroplakia?
Which clinical presentation helps distinguish erythematous candidiasis from erythroplakia?
What characterizes the chronic plaque-type candidiasis?
What characterizes the chronic plaque-type candidiasis?
Which secondary oral candidiasis condition is commonly seen alongside systemic conditions like AIDS?
Which secondary oral candidiasis condition is commonly seen alongside systemic conditions like AIDS?
Which clinical type of Oral Lichen Planus is characterized by a network of fine white lines?
Which clinical type of Oral Lichen Planus is characterized by a network of fine white lines?
What distinguishes the papular form of Oral Lichen Planus from the reticular form?
What distinguishes the papular form of Oral Lichen Planus from the reticular form?
What is a distinctive feature of denture stomatitis?
What is a distinctive feature of denture stomatitis?
In which area is the most frequent extra-oral mucosa site of Oral Lichen Planus lesions observed?
In which area is the most frequent extra-oral mucosa site of Oral Lichen Planus lesions observed?
What is the underlying etiology of Oral Lichen Planus?
What is the underlying etiology of Oral Lichen Planus?
What is the primary clinical manifestation of acute pseudomembranous candidiasis?
What is the primary clinical manifestation of acute pseudomembranous candidiasis?
Which of the following age groups is at an increased risk for Candida infections due to age-related factors?
Which of the following age groups is at an increased risk for Candida infections due to age-related factors?
What triggers the 'Koebner phenomenon' in skin lesions?
What triggers the 'Koebner phenomenon' in skin lesions?
Which clinical diagnosis feature distinguishes reticular and papular types from other Oral Lichen Planus manifestations?
Which clinical diagnosis feature distinguishes reticular and papular types from other Oral Lichen Planus manifestations?
Burning sensations in the mouth, especially when consuming spicy foods, are associated with which condition?
Burning sensations in the mouth, especially when consuming spicy foods, are associated with which condition?
Which of the following types of Oral Lichen Planus typically presents with asymptomatic lesions?
Which of the following types of Oral Lichen Planus typically presents with asymptomatic lesions?
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Study Notes
Oral Complications
- Loss of resilience in the mouth can affect speech, tongue mobility, and mouth opening.
- A burning sensation, especially with spicy food, can be present.
- The lips, buccal mucosa, retromolar area, and soft palatal mucosa are the most common sites for oral complications.
Oral Lichen Planus
- A relatively common dermatosis affecting both skin and oral mucous membranes.
- 50% of patients exhibit oral and skin lesions.
- The etiology is multifactorial, with a cell-mediated immune response leading to basal cell layer degeneration. Stress can also be a contributing factor.
- Skin lesions involve flat-topped papules, often itchy and having a violaceous color, with fine scaling on the surface. These lesions are more commonly found on the trunk and flexor surfaces of the arms and legs.
- The genital mucosa is a frequent extra-oral site involved.
- Scratching often provides relief but can also lead to new skin lesions, known as the Koebner phenomenon.
Lichenoid Drug Eruptions
- Clinically and histologically similar to OLP.
- Certain drugs or their metabolites can act as haptens, triggering a lichenoid reaction (delayed hypersensitivity).
- Common culprits include penicillin, gold, NSAIDs, and sulfonamides.
- Skin lesions resemble those seen in OLP.
- Discontinuation of the offending drug typically results in resolution, with symptomatic treatment using topical steroids.
Classification of Soft Tissue Lesions
- Flat lesions: Macule, Patch
- Depressed lesions: Erosion, Fissure, Ulcer
- Raised lesions: Papule, Plaque, Nodule, Vesicle, Bulla, Pustule
Macule
- A flat circumscribed area of epidermis or mucosa, less than 1 cm in diameter.
- Distinguished from the surroundings by color, which can be red, pigmented (blue, brown, or black) due to melanin or foreign materials.
Patch
- A flat circumscribed area, neither elevated nor depressed, larger than 1 cm in diameter.
- Differentiated from its surroundings by color, texture, or both.
Papule
- A superficial elevated solid lesion, smaller than 1 cm in diameter.
- An example is lichen planus papules (skin lesions).
Plaque
- A flat solid raised area greater than 1 cm in diameter.
- Examples include lichen planus and leukoplakia.
Nodule
- A solid elevated mass of tissue, less than 1 cm in diameter.
- It extends deeper into the tissue than a papule. The overlying mucosa is not fixed and can be easily moved over the lesion.
- Examples include benign tumors like fibroma and lipoma.
Vesicle
- A circumscribed fluid-filled elevation in the mucosa, less than 1 cm in diameter.
- The fluid consists of lymph and serum.
- The epithelial lining is thin and can break down, leading to an ulcer.
- Common in viral infections like herpes simplex, herpes zoster, and chicken pox.
Bulla
- A fluid-filled elevation, greater than 1 cm in diameter.
- An example is Candida albicans tissue invasion.
Predisposing Factors for Candidiasis
- Changes in oral microbial flora following antibiotic administration.
- Chronic local irritants, such as dentures.
- Corticosteroids.
- Radiation of the head and neck.
- Age (infancy to old age).
- Immune status.
- Hospitalization.
- Smoking.
- Xerostomia (dry mouth).
Classification of Oral Candidiasis
- Primary oral candidiasis:
- Acute: Pseudomembranous, Erythematous.
- Chronic: Pseudomembranous, Erythematous, Plaque-like, Nodular.
- Secondary oral candidiasis: Accompanied by systemic mucocutaneous manifestations like AIDS and DiGeorge syndrome.
Candida Associated Lesions
- Denture Stomatitis: The most prevalent site is the denture-bearing palatal mucosa. The denture acts as a vehicle for accumulating sloughed epithelial cells and protects microorganisms from salivary flow.
- Angular Chelitis: Inflammation at the corners of the mouth.
- Median Rhomboid Glossitis: A smooth red, diamond-shaped area, usually on the dorsal midline of the tongue.
Pseudomembranous Candidiasis (Thrush)
- Acute form: Predominantly affects patients medicated with antibiotics and immunosuppressant drugs.
- Chronic form: Associated with human immunodeficiency virus (HIV) patients and patients using steroid inhalers.
Erythematous Candidiasis (Atrophic)
- Characterized by diffuse borders, distinguishing it from erythroplakia which has a sharper demarcation.
- Found on the palate and dorsal surface of the tongue of patients using broad-spectrum antibiotics, smokers, or those using inhaled steroids.
Chronic Plaque-Type and Nodular Candidiasis (Candidal Leukoplakia)
- Characterized by white irremovable plaques that are indistinguishable from oral leukoplakia.
- Associated with malignant transformation.
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