Oral Mucosa Red and White Lesions

Questions and Answers

Which form of Candida is considered pathogenic?

Both forms

Hyphae (correct)

Spores

Neither form

What percentage of people are carriers of C.albicans?

30%

Over 60% (correct)

60%

50%

Which of the following is NOT a predisposing factor for oral candidiasis?

Corticosteroids

Good nutrition (correct)

High carbohydrate diet

Poor oral hygiene

Which group of individuals is most at risk for opportunistic Candida infections?

Very young, very old, and very sick Signup and view all the answers

What are the typical manifestations of candidiasis?

Red or white lesions Signup and view all the answers

What condition can lead to a whitish appearance of the oral mucosa due to increased production of keratin?

Hyperkeratosis Signup and view all the answers

Which of the following is NOT a cause of red lesions in the oral mucosa?

Acanthosis Signup and view all the answers

What is the significance of palpation in diagnosing oral lesions?

To assess the consistency and texture Signup and view all the answers

Which factor is NOT part of the clinical approach to differential diagnosis of oral lesions?

Presence of new hair growth Signup and view all the answers

What common clinical sign may indicate a possible malignancy in oral lesions?

Indurated lesion texture Signup and view all the answers

What can cause white lesions due to intra- and extracellular accumulation of fluid?

Epithelial edema Signup and view all the answers

Which condition is identified as the most prevalent opportunistic infection affecting the oral mucosa?

Oral Candidiasis Signup and view all the answers

Which of these factors is associated with a significant increase in vascularity in oral lesions?

Vascular dilation Signup and view all the answers

Which of the following is a common cause of pseudomembranous candidiasis?

Immunosuppressant drugs Signup and view all the answers

What form of pseudomembranous candidiasis is most frequently observed?

Acute form Signup and view all the answers

What are the clinical features of oral thrush?

Thick creamy-white plaques that can be wiped off Signup and view all the answers

Which antifungal medication is suitable for treating severe cases of candidiasis?

Fluconazole Signup and view all the answers

Which of the following factors is not a main predisposing factor for candidiasis?

Excessive physical activity Signup and view all the answers

Which diagnostic method could be used to examine candidiasis?

Periodic acid-Schiff (PAS) stained smear Signup and view all the answers

What is the most effective initial treatment approach for candidiasis?

Correction of predisposing factors and antifungal medication Signup and view all the answers

What is a potential side effect of Fluconazole?

Drug interaction with warfarin Signup and view all the answers

What is the primary method for diagnosing Type III inflammatory papillary hyperplasia?

Clinical evaluation and history Signup and view all the answers

Which treatment is NOT recommended for chronic atrophic candidiasis?

Store denture in reduced temperature Signup and view all the answers

Which solution should NOT be used for denture storage at night?

Distilled water Signup and view all the answers

What is the likely reason for recurrent angular cheilitis if treatment is ineffective?

Failure to treat intraoral infection Signup and view all the answers

Which of the following is a predisposing factor for angular cheilitis?

Over closure of the mouth Signup and view all the answers

What is the presentation of angular cheilitis?

Red fissures at the corners of the mouth Signup and view all the answers

Which treatment is used for angular cheilitis?

Miconazole gel or fusidic acid cream Signup and view all the answers

Which factor is NOT associated with increased intraoral Candida levels leading to angular cheilitis?

Infrequent dental visits Signup and view all the answers

What is a common clinical feature of median rhomboid glossitis?

Asymptomatic red rhomboid area on the midline dorsum of the tongue Signup and view all the answers

Which treatment is NOT typically recommended for chronic hyperplastic candidiasis?

Systemic antibiotic therapy Signup and view all the answers

What is a significant predisposing factor for both median rhomboid glossitis and chronic hyperplastic candidiasis?

Smoking Signup and view all the answers

In patients with HIV, what is the significance of a CD4 cell count in relation to oral candidiasis?

Lower counts correlate with increased prevalence and severity of oral candidiasis Signup and view all the answers

Which feature distinguishes chronic hyperplastic candidiasis from other oral lesions?

Leukoplakia-like lesion that cannot be rubbed off Signup and view all the answers

Study Notes

Red and White Oral Lesions

Red and white lesions affect the oral mucosa's lining, caused by factors like trauma, infection, inflammation, and cancer.
White lesions arise from conditions such as hyperkeratosis, acanthosis, epithelial edema, fungal infections, and subepithelial superficial fibrosis.
Red lesions result from atrophy, superficial erosion, increased vascularization from inflammation, or cellular proliferation indicating possible malignancy.
Consistency and texture are crucial for diagnosis; palpation is vital for identifying indurated lesions that may suggest malignancy.

Clinical Assessment

Consider factors like age, pain, lesion type (single or multiple), borders, onset, duration, and changes in shape or size.
Systemic conditions and medications can correlate with oral diseases, necessitating a comprehensive patient history.

Oral Candidiasis

The most prevalent opportunistic infection in the oral mucosa, primarily caused by Candida species, especially C. albicans.
C. albicans is a normal microflora component in over 60% of people, presenting in pathogenic hyphal form and non-pathogenic spore form.
Opportunistic infections occur in immunocompromised individuals, and candidiasis may manifest as red or white lesions, either acute or chronic.

Predisposing Factors

Local factors include poor oral hygiene, smoking, xerostomia, corticosteroid use, long-term antibiotic use, and high carbohydrate diets.
General factors encompass immunosuppressive diseases (e.g., HIV), systemic corticosteroids, hematological malignancies, endocrine disturbances, and nutritional deficiencies.

Diagnosis Methods

Clinical examination and biopsy are essential, along with PAS-stained smears and saliva culture.
Further tests may be necessary to clarify unclear predisposing factors.

Treatment Strategies

Address predisposing factors alongside antifungal medications.
Topical agents like Nystatin and Miconazole gel for mild cases; systemic antifungals like Fluconazole for severe cases.

Types of Oral Candidiasis

Pseudomembranous Candidiasis (Oral Thrush): Characterized by creamy-white plaques, easily removable, leaving an erythematous base. Often associated with antibiotic use and immune suppression.
Inflammatory Papillary Hyperplasia: Diagnosed through clinical history; a smear may be performed.
Chronic Atrophic Candidiasis (Denture-Related Stomatitis): Prevented by improved denture hygiene and ceasing nighttime wear.
Angular Cheilitis: Presentation of red fissures at oral commissures, often caused by a combination of Candida and bacterial infections.

Median Rhomboid Glossitis

Asymptomatic red area on the tongue's midline, resulting from atrophy of the filiform papillae. Often requires reassurance and antifungal treatment.

Chronic Hyperplastic Candidiasis

Presents as an asymptomatic white plaque that cannot be wiped off, often considered potentially malignant. Requires smoking cessation, antifungal treatment, and possible biopsy.

Oral Candidiasis in HIV Patients

Common in over 90% of AIDS patients, linked to the degree of immunosuppression. Difficult to eradicate; close monitoring is essential.

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Description

Explore the various conditions affecting the oral mucosa, particularly focusing on red and white lesions. This quiz covers causes such as trauma, infections, and abnormal tissue responses like hyperkeratosis and acanthosis. Test your knowledge on the characteristics and implications of these oral lesions.