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Questions and Answers
What is the term for a localized area of disease or injury in any organ or tissue of the body?
What is the term for a localized area of disease or injury in any organ or tissue of the body?
Lesion
Which of the following is NOT a type of white lesion in the oral mucosa?
Which of the following is NOT a type of white lesion in the oral mucosa?
Leukoedema can be scraped off the surface of the oral mucosa.
Leukoedema can be scraped off the surface of the oral mucosa.
False
What is the most common cause of a burn in the oral mucosa?
What is the most common cause of a burn in the oral mucosa?
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Which of the following is a differential diagnosis for a chemical burn?
Which of the following is a differential diagnosis for a chemical burn?
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Uremic stomatitis occurs in patients with severe untreated renal failure.
Uremic stomatitis occurs in patients with severe untreated renal failure.
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What is the term for a group of lesions with different etiologies but a common clinical and histologic appearance?
What is the term for a group of lesions with different etiologies but a common clinical and histologic appearance?
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Which of the following is NOT a type of oral lichenoid reaction?
Which of the following is NOT a type of oral lichenoid reaction?
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What is the most disabling form of oral lichen planus (OLP)?
What is the most disabling form of oral lichen planus (OLP)?
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The reticular form of OLP is usually present in the initial phase of the disease
The reticular form of OLP is usually present in the initial phase of the disease
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What is the common clinical characteristic of the papular form of OLP?
What is the common clinical characteristic of the papular form of OLP?
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The plaque-like form of OLP can be easily distinguished from oral leukoplakias.
The plaque-like form of OLP can be easily distinguished from oral leukoplakias.
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Which of the following conditions is not a differential diagnosis for erythematous (atrophic) OLP?
Which of the following conditions is not a differential diagnosis for erythematous (atrophic) OLP?
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What is the most common treatment strategy for OLP?
What is the most common treatment strategy for OLP?
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Radiation mucositis usually develops within the first week of radiation therapy.
Radiation mucositis usually develops within the first week of radiation therapy.
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What is the common characteristic of Koplik's spots?
What is the common characteristic of Koplik's spots?
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Which of the following is NOT a differential diagnosis for Koplik's spots?
Which of the following is NOT a differential diagnosis for Koplik's spots?
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Where does stomatitis nicotina palati occur?
Where does stomatitis nicotina palati occur?
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Stomatitis nicotina palati is considered a premalignant lesion.
Stomatitis nicotina palati is considered a premalignant lesion.
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Which of the following clinical features is NOT associated with stomatitis nicotina palati?
Which of the following clinical features is NOT associated with stomatitis nicotina palati?
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What is the initial appearance of stomatitis nicotina palati?
What is the initial appearance of stomatitis nicotina palati?
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Traumatic keratosis is more common in young adults.
Traumatic keratosis is more common in young adults.
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Describe the appearance of traumatic keratosis.
Describe the appearance of traumatic keratosis.
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Which of the following is NOT a differential diagnosis for traumatic keratosis?
Which of the following is NOT a differential diagnosis for traumatic keratosis?
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White spongy nevus is a rare genetic disease that can be present at birth.
White spongy nevus is a rare genetic disease that can be present at birth.
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What are the two main conditions related to denture wear?
What are the two main conditions related to denture wear?
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Denture sore mouth (DSM) is always accompanied by pain.
Denture sore mouth (DSM) is always accompanied by pain.
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What is the most common cause of denture sore mouth (DSM) and papillary hyperplasia (PH)?
What is the most common cause of denture sore mouth (DSM) and papillary hyperplasia (PH)?
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Study Notes
Red and White Oral Lesions
- Oral lesions can have a variety of appearances, white or red, due to several factors
- White lesions can be caused by:
- Increased keratin production (hyperkeratosis)
- Abnormal thickening of the stratum spinosum (acanthosis)
- Fluid buildup inside or outside the epithelium
- Necrosis (cell death) of the epithelium from toxins
- Microbial growth, particularly fungal, leading to pseudomembranes made of shed cells, fungus, and immune cells
- Red lesions are associated with:
- Epithelial atrophy (thinning)
- Increased vascularization (blood vessel growth)
Classifications of Red and White Lesions
- Based on variations from normal appearances and whether keratosis (a buildup of keratin) is present or not
- Example classifications:
- Linea alba
- Fordyce granules
- Leukoedema
Additional Oral Lesions
- Uremic stomatitis: Occurs in severe renal failure patients
- Radiation mucositis: A complication of radiation therapy for head/neck cancer, characterized by redness followed by a pseudomembrane covering and greyish white slough.
- Oral candidiasis (various types, e.g., acute pseudomembranous, atrophic, and hypertrophic forms)
- Keratotic white lesions: Lesions with no increased potential for cancer (e.g., stomatitis nicotina palati, traumatic keratosis, focal epithelial hyperplasia, psoriasis).
- Red and white lesions with unknown or increased malignant potential: Include conditions such as leukoplakia, erythroplakia, oral submucous fibrosis, and lichen planus.
- Lichenoid reactions: A group of lesions with common clinical and histologic features, linked to several disorders from contact reactions to graft-versus-host disease (GVHD).
- Oral lichen planus: Characterized by red, white, and slightly raised, textured, or papular components.
Specific Lesions: Details
- Linea alba: A white horizontal line in the buccal mucosa.
- Fordyce's granules: Small yellowish-white spots of ectopic sebaceous glands.
- Leukoedema: Bilaterally faint (mild) whitish-gray diffuse opacity that disappears on stretching
- Habitual cheek/lip biting: White plaques with rough surface on the buccal mucosa or lips, frequently caused by excessive biting.
- Burns (thermal and chemical): Often from hot beverages/foods or chemicals like aspirin, resulting in white pseudomembrane-covered, painful lesions that can be ulcerated.
- Koplik's spots: Small, white spots indicative of measles.
Additional Specific Conditions
- White spongy nevus: Rare genetic disorder, characterized by bilaterally symmetrical white spongy, thick plaques predominantly on buccal mucosa.
- Denture sore mouth (DSM) and Papillary hyperplasia (PH): related to denture wearing, leading to red, sometimes pebbly/raised areas on the palate.
- Stomatitis nicotina palati: A white lesion found more frequently in heavy tobacco smokers within the palatal mucosa
- Discoid lupus erythematosus: Similar striae as oral lichen planus but more prominent, more marked keratinization, and may abruptly terminate at a clear boundary.
- Mucous membrane pemphigoid: Epithelium easily detached from connective tissue due to a force (Nikolsky's sign).
- Erythema multiforme: Doesn't usually show reticular or papular elements in the periphery of the lesions.
Treatment and Diagnosis
- Treatment strategies focus on addressing the underlying cause and alleviating symptoms.
- Diagnosis often involves careful observation, biopsies, and/or other specific diagnostic testing.
Important Note
- This is a summary of a broad range of conditions. Not all white or red oral lesions are discussed in this bullet point list. Detailed diagnosis by a medical professional is essential.
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Description
This quiz explores various oral lesions characterized by red and white appearances. It covers causes, classifications, and specific examples of these lesions. Perfect for students of dentistry or for anyone interested in oral health.
