Oral Lesions: Red and White Variants
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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?

Lesion

Which of the following is NOT a type of white lesion in the oral mucosa?

  • Fordyce granules
  • Linea alba
  • Erythroplakia (correct)
  • Leukoplakia

Leukoedema can be scraped off the surface of the oral mucosa.

False (B)

What is the most common cause of a burn in the oral mucosa?

<p>Intake of hot beverages or foods</p> Signup and view all the answers

Which of the following is a differential diagnosis for a chemical burn?

<p>Candidiasis (D)</p> Signup and view all the answers

Uremic stomatitis occurs in patients with severe untreated renal failure.

<p>True (A)</p> Signup and view all the answers

What is the term for a group of lesions with different etiologies but a common clinical and histologic appearance?

<p>Lichenoid reactions</p> Signup and view all the answers

Which of the following is NOT a type of oral lichenoid reaction?

<p>Discoid lupus erythematosus (D)</p> Signup and view all the answers

What is the most disabling form of oral lichen planus (OLP)?

<p>Ulcerative lesions</p> Signup and view all the answers

The reticular form of OLP is usually present in the initial phase of the disease

<p>False (B)</p> Signup and view all the answers

What is the common clinical characteristic of the papular form of OLP?

<p>Small white dots</p> Signup and view all the answers

The plaque-like form of OLP can be easily distinguished from oral leukoplakias.

<p>False (B)</p> Signup and view all the answers

Which of the following conditions is not a differential diagnosis for erythematous (atrophic) OLP?

<p>Candidiasis (A)</p> Signup and view all the answers

What is the most common treatment strategy for OLP?

<p>Reducing or eliminating symptoms</p> Signup and view all the answers

Radiation mucositis usually develops within the first week of radiation therapy.

<p>True (A)</p> Signup and view all the answers

What is the common characteristic of Koplik's spots?

<p>Small, white spots</p> Signup and view all the answers

Which of the following is NOT a differential diagnosis for Koplik's spots?

<p>Candidiasis (B)</p> Signup and view all the answers

Where does stomatitis nicotina palati occur?

<p>Hard and soft palate</p> Signup and view all the answers

Stomatitis nicotina palati is considered a premalignant lesion.

<p>False (B)</p> Signup and view all the answers

Which of the following clinical features is NOT associated with stomatitis nicotina palati?

<p>Sex: Females &gt; Males (D)</p> Signup and view all the answers

What is the initial appearance of stomatitis nicotina palati?

<p>Red burn-like lesions</p> Signup and view all the answers

Traumatic keratosis is more common in young adults.

<p>True (A)</p> Signup and view all the answers

Describe the appearance of traumatic keratosis.

<p>Well-defined, white plaque</p> Signup and view all the answers

Which of the following is NOT a differential diagnosis for traumatic keratosis?

<p>Fordyce granules (B)</p> Signup and view all the answers

White spongy nevus is a rare genetic disease that can be present at birth.

<p>True (A)</p> Signup and view all the answers

What are the two main conditions related to denture wear?

<p>Denture sore mouth (DSM) and Papillary hyperplasia (PH)</p> Signup and view all the answers

Denture sore mouth (DSM) is always accompanied by pain.

<p>False (B)</p> Signup and view all the answers

What is the most common cause of denture sore mouth (DSM) and papillary hyperplasia (PH)?

<p>Candida albicans</p> Signup and view all the answers

Flashcards

What is a lesion?

A localized area of disease or injury in any organ or tissue of the body.

What is a papule?

A well-circumscribed, solid, raised lesion up to 1 cm in diameter.

What is a plaque?

A well-circumscribed, solid, raised lesion more than 1 cm in diameter.

What is Linea Alba?

A white line, a horizontal streak on the buccal mucosa at the level of the occlusal plane extending from the commissure to the posterior teeth.

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What are Fordyce's Granules/Spots?

Ectopic sebaceous glands within normal mucosa, present in 80 to 90% of the population.

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What is Leukoedema?

A common mucosal alteration seen on the buccal mucosa, appearing as a faint white diffuse and filmy appearance with many surface folds resulting in surface wrinkling, not scrappable, and disappears on stretching.

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What is Habitual Cheek/Lip Biting?

A white plaque with rough surface on the buccal mucosa or lips, appearing paler than surrounding tissue, caused by stress-related biting.

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What is Uremic Stomatitis?

A condition that occurs in severe, untreated renal failure (chronic) patients, characterized by a red, inflamed, and often ulcerated oral mucosa.

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What are Lichenoid Reactions?

A family of lesions with different etiologies sharing a common clinical and histologic appearance, including disorders like Lichen Planus, Lichenoid Contact Reactions, Lichenoid Drug Eruptions, and Lichenoid Reactions of Graft-versus-Host Disease (GVHD).

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What is Oral Lichen Planus (OLP)?

A chronic inflammatory disease that can affect the skin, hair, and nails, and can also occur in the mouth, with characteristic white lace-like patterns and red patches.

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What is Reticular OLP?

The form of OLP characterized by fine white lines or striae, often forming a network or annular (circular) patterns, frequently appearing in buccal mucosa, sometimes on the mucosal side of the lips or at the vermilion border.

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What is Papular OLP?

The form of OLP that typically presents in the initial phase of the disease, characterized by small white dots that often intermingle with the reticular form.

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What is Plaque-type OLP?

The form of OLP presenting as a homogeneous, well-demarcated white plaque, often surrounded by striae, frequently seen in smokers and possibly transforming into oral squamous cell carcinomas.

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What is Erythematous (Atrophic) OLP?

The form of OLP characterized by a homogeneous red area, often with striae in the periphery, sometimes affecting only the attached gingiva, and potentially presenting as desquamative gingivitis.

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What is Ulcerative OLP?

The most disabling form of OLP, characterized by fibrin-coated ulcers surrounded by an erythematous zone with radiating white striae.

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What is Radiation Mucositis?

A condition that develops at the end of the first week of radiation therapy for head and neck cancers, presenting as redness followed by a pseudomembrane covered with greyish white slough.

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What is Stomatitis Nicotina Palati (Smoker's Palate)?

A small, discrete white lesion that develops on the hard and soft palate in heavy cigarette, pipe and cigar smokers, restricted to areas exposed to concentrated hot smoke.

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What is Traumatic Keratosis?

A well-defined, white plaque, non-scrapable, often with loss of strechability of the affected mucosa, commonly found in the buccal mucosa, gingiva, and lateral aspect of the tongue.

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What is White Spongy Nevus (Oral Genodermatosis)?

A rare genetic disease, present at birth, characterized by bilaterally symmetrical white spongy thick plaques on the buccal mucosa, typically asymptomatic.

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What is Denture Sore Mouth (DSM)?

A condition related to wearing dentures, typically appearing as small, red, localized spots on the posterior palatal mucosa, which can worsen into large red areas and then develop papillary hyperplasia.

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What is Papillary Hyperplasia (PH)?

A condition that develops in later stages of denture sore mouth, characterized by hyperplasia of the palatal mucosa, producing a red, pebbly appearance.

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What is Linea Alba?

A condition caused by pressure, frictional irritation or sucking trauma, resulting in a white horizontal line on the buccal mucosa.

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What are Fordyce's Granules/Spots?

Small, yellowish-white or white papules caused by ectopic sebaceous glands in the mucosa, present in a large majority of the population and appearing around puberty.

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What is Leukoedema?

A condition that appears faint white, diffuse, and filmy with surface wrinkling, not scrappable, and disappears on stretching, caused by an increase in edema in the epithelium.

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What is Habitual Cheek/Lip Biting?

A condition that appears as a well-defined, white plaque with rough surface on the buccal mucosa or lips, with the affected area appearing paler than surrounding tissue, caused by repeated biting.

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What is Uremic Stomatitis?

A condition that presents in severe, untreated kidney failure (chronic) patients, causing red, inflamed, and often ulcerated oral mucosa.

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What are Lichenoid Reactions?

A group of lesions with different causes but similar clinical and histologic appearance, including Lichen Planus, Lichenoid Contact Reactions, Lichenoid Drug Eruptions, and Lichenoid Reactions of Graft-versus-Host Disease (GVHD).

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What is Oral Lichen Planus (OLP)?

A chronic inflammatory disease that can affect the skin, hair, and nails, and can also occur in the mouth, often presenting as white lace-like patterns and red patches.

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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.

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