Oral Lesions and Prognosis Quiz

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Questions and Answers

Describe the clinical presentation of poor prognosis leukoplakia, focusing on both appearance and location.

Poor prognosis leukoplakia often presents with a speckled appearance (combining erythroplakia and leukoplakia), a nodular surface, exophytic growth, increased firmness or induration, and unexplained hemorrhage. Common sites include the lateral border of the tongue, ventral surface of the tongue, floor of the mouth, and retromolar areas.

What are the significant differences between leukoplakia and proliferative verrucous leukoplakia in terms of prognosis and malignant transformation rates?

Leukoplakia can be managed with conservative measures including smoking cessation and balanced diet, with a 70% chance of regression. In contrast, proliferative verrucous leukoplakia has a high malignant transformation rate (50-70%) and a strong tendency to recur after treatment.

Outline the recommended management approaches for mild dysplasia associated with leukoplakia.

Management for mild dysplasia includes smoking cessation, alcohol reduction, a balanced diet rich in fruits and vegetables, and treatment of any candidal infections. Regular monitoring every 6 months is also crucial.

What is the primary treatment strategy for moderate and severe dysplasia associated with leukoplakia?

Moderate and severe dysplasia necessitates surgical excision or laser removal to eliminate the dysplastic tissue and minimize the risk of progression. Signup and view all the answers

Describe the key clinical features of proliferative verrucous leukoplakia, including its development and typical anatomical locations.

Proliferative verrucous leukoplakia typically begins as a white patch that gradually develops into multiple exophytic, wart-like lesions. It is primarily observed in the buccal mucosa, gingiva, and tongue. Signup and view all the answers

How does the clinical presentation of submucous fibrosis differ from leukoplakia, and what is the primary etiological factor associated with submucous fibrosis?

Submucous fibrosis is characterized by progressive fibrosis affecting the hard and soft palate, fauces, and cheeks, leading to restricted mobility. This differs from leukoplakia, which primarily affects the mucosal surface. Betel nut chewing (areca nut) is the primary etiological factor associated with submucous fibrosis. Signup and view all the answers

Explain the significance of the high recurrence rate associated with proliferative verrucous leukoplakia and submucous fibrosis in terms of patient management.

The high recurrence rates associated with proliferative verrucous leukoplakia and submucous fibrosis necessitate long-term follow-up and multiple surgical interventions to control the lesions and minimize the risk of malignancy. Signup and view all the answers

What are the different treatment approaches for proliferative verrucous leukoplakia and submucous fibrosis, and what are the challenges associated with each approach?

Proliferative verrucous leukoplakia is typically treated through surgical resection, although there's a high rate of recurrence, often necessitating multiple interventions. Submucous fibrosis treatment primarily focuses on preventing further progression through cessation of betel nut chewing and supportive measures like corticosteroid therapy. The challenge in both conditions is maintaining long-term control and managing persistent lesions. Signup and view all the answers

What clinical findings are indicative of sublingual keratosis?

Irregular, diffuse, flat white patches on the mucosa, pale and firm appearance, and limited mouth opening due to fibrosis. Signup and view all the answers

Explain the role of biopsy in the management of sublingual keratosis.

A biopsy assesses the presence of dysplasia; if moderate to severe dysplasia is present, surgical or laser removal may be indicated. Signup and view all the answers

What are the histological features associated with sublingual keratosis?

Histological features include atrophy of the epithelium, possible dysplasia, fibrosis with excess Type 1 collagen, and mild to moderate chronic inflammation. Signup and view all the answers

Identify two symptoms experienced by patients with sublingual keratosis.

Patients may experience a burning sensation and pain due to atrophy of the tissue. Signup and view all the answers

What is the significance of monitoring patients with no dysplasia or mild dysplasia in sublingual keratosis?

Regular monitoring helps to identify any progression of dysplasia, which could indicate an increased risk of malignancy. Signup and view all the answers

What differentiates sublingual keratosis from other oral conditions like leukodema?

Leukodema is a normal variation of mucosal appearance, while sublingual keratosis is a potentially malignant disorder characterized by chronic irritation. Signup and view all the answers

How can the cessation of betel nut usage affect the management of sublingual keratosis?

Discontinuation of betel nut can reduce chronic irritation, potentially alleviating symptoms and preventing progression of the condition. Signup and view all the answers

What is the primary treatment approach for patients with moderate to severe dysplasia in sublingual keratosis?

The primary treatment approach involves surgical or laser removal of the lesions. Signup and view all the answers

Flashcards

Clinical Diagnosis

Diagnosis can be made from clinical history and examination.

Biopsy Purpose

A biopsy rules out malignancy in suspicious cases.