Podcast
Questions and Answers
What pathology is observed in angular stomatitis and what does a Gram-stained smear typically show?
What pathology is observed in angular stomatitis and what does a Gram-stained smear typically show?
A Gram-stained smear shows large masses of tangled hyphae, detached epithelial cells, and leucocytes.
What are the suggested topical treatments for oral candidiasis?
What are the suggested topical treatments for oral candidiasis?
Topical antifungals such as Nystatin or amphotericin lozenges are suggested for treatment.
What does a failure to respond to topical antifungals in a patient indicate?
What does a failure to respond to topical antifungals in a patient indicate?
It suggests an underlying immune deficiency.
What is acute antibiotic stomatitis and what can lead to its development?
What is acute antibiotic stomatitis and what can lead to its development?
Signup and view all the answers
What factors can lead to generalized candidal erythema in the oral cavity?
What factors can lead to generalized candidal erythema in the oral cavity?
Signup and view all the answers
In denture-induced stomatitis, what clinical features are typically observed?
In denture-induced stomatitis, what clinical features are typically observed?
Signup and view all the answers
What histological features are typical in denture-induced stomatitis?
What histological features are typical in denture-induced stomatitis?
Signup and view all the answers
What are the main categories of cleansers used for denture hygiene?
What are the main categories of cleansers used for denture hygiene?
Signup and view all the answers
What characterizes candidiasis endocrinopathy syndrome (CES)?
What characterizes candidiasis endocrinopathy syndrome (CES)?
Signup and view all the answers
Explain the difference between localized and diffuse CMC.
Explain the difference between localized and diffuse CMC.
Signup and view all the answers
What is the role of systemic antifungal drugs in managing CMC?
What is the role of systemic antifungal drugs in managing CMC?
Signup and view all the answers
List two strategies to reduce the risk of oral candidiasis.
List two strategies to reduce the risk of oral candidiasis.
Signup and view all the answers
Why is maintenance of good oral and denture hygiene important?
Why is maintenance of good oral and denture hygiene important?
Signup and view all the answers
How does glucose intake affect oral candidiasis?
How does glucose intake affect oral candidiasis?
Signup and view all the answers
What is the effectiveness of nystatin tablets compared to oral suspension?
What is the effectiveness of nystatin tablets compared to oral suspension?
Signup and view all the answers
How can heavy candidal plaques be effectively removed from oral lesions?
How can heavy candidal plaques be effectively removed from oral lesions?
Signup and view all the answers
What is the characteristic appearance of oral hairy leukoplakia and what is its primary association?
What is the characteristic appearance of oral hairy leukoplakia and what is its primary association?
Signup and view all the answers
Identify two important predisposing factors for oral candidosis.
Identify two important predisposing factors for oral candidosis.
Signup and view all the answers
Describe the histopathological features associated with oral hairy leukoplakia.
Describe the histopathological features associated with oral hairy leukoplakia.
Signup and view all the answers
What is the most common form of oral candidosis and describe its clinical features?
What is the most common form of oral candidosis and describe its clinical features?
Signup and view all the answers
What treatment is typically effective for oral hairy leukoplakia in HIV patients?
What treatment is typically effective for oral hairy leukoplakia in HIV patients?
Signup and view all the answers
Explain what is meant by the phrase 'disease of the diseased' in relation to oral candidosis.
Explain what is meant by the phrase 'disease of the diseased' in relation to oral candidosis.
Signup and view all the answers
What are the common clinical manifestations of angular stomatitis in oral candidosis?
What are the common clinical manifestations of angular stomatitis in oral candidosis?
Signup and view all the answers
List two forms of oral candidiasis beyond thrush and describe their characteristics.
List two forms of oral candidiasis beyond thrush and describe their characteristics.
Signup and view all the answers
What are the two types of lytic enzymes mentioned that are effective against infections?
What are the two types of lytic enzymes mentioned that are effective against infections?
Signup and view all the answers
What solution is effective in completely eradicating C albicans from denture surfaces?
What solution is effective in completely eradicating C albicans from denture surfaces?
Signup and view all the answers
How does a 0.12% chlorhexidine gluconate oral rinse impact C albicans on dentures?
How does a 0.12% chlorhexidine gluconate oral rinse impact C albicans on dentures?
Signup and view all the answers
What is the characteristic sign of angular stomatitis?
What is the characteristic sign of angular stomatitis?
Signup and view all the answers
Which condition is defined by erythematous patches of atrophic papillae on the tongue?
Which condition is defined by erythematous patches of atrophic papillae on the tongue?
Signup and view all the answers
What distinguishes candidal leukoplakia from other forms of leukoplakia?
What distinguishes candidal leukoplakia from other forms of leukoplakia?
Signup and view all the answers
What are the prominent lesions of chronic mucocutaneous candidiasis (CMC)?
What are the prominent lesions of chronic mucocutaneous candidiasis (CMC)?
Signup and view all the answers
Which diet is recommended to be avoided to prevent candidiasis infections?
Which diet is recommended to be avoided to prevent candidiasis infections?
Signup and view all the answers
Study Notes
White & Red Lesions
- Infectious oral white lesions are identified as a lecture topic.
- Causes and different forms of oral candidiasis are part of the lecture objectives.
- White lesions include hereditary, reactive/inflammatory, infectious, idiopathic leukoplakia, erythroplakia, lichen planus, lupus erythematosus, and miscellaneous types.
Oral Hairy Leukoplakia
- Oral hairy leukoplakia is a corrugated white keratotic lesion.
- Typically found on the lateral or ventral surfaces of the tongue.
- Commonly linked to severe immunodeficiency, particularly HIV infection.
- The Epstein-Barr virus (EBV) is the causative agent.
Histopathology of Oral Hairy Leukoplakia
- Hyperparakeratosis with an irregular surface.
- Acanthosis with superficial edema.
- Koilocytic cells (virally affected cells) in the spinous layer.
- Homogenous viral nuclear inclusions with a rim of normal chromatin are present.
Oral Candidiasis (Thrush)
- Oral candidiasis is a common fungal infection in patients with other diseases or conditions.
- It's not a spontaneous condition.
- Candida are normal oral inhabitants; various predisposing factors, like immunodeficiency, poor oral hygiene, and pregnancy, lead to candidiasis.
Treatment & Prognosis of Oral Candidiasis
- Antifungal medications (like acyclovir) help resolve the condition.
- Treatment of HIV infection can alleviate oral candidiasis.
Types of Oral Candidiasis
- Acute Pseudomembranous Candidiasis (Thrush): characterized by painless plaques on oral mucosa.
- Erythematous Candidiasis: marked by red macules (spots) on the oral mucosa, commonly associated with HIV.
- Candidal Leukoplakia (Hyperplastic Candidiasis):firm white leathery plaques on the oral mucosa, linked to deeper Candida invasion.
Additional types of oral candidosis (spectrums)
- Acute/Chronic Candidiasis, Pseudomembranous candidosis, Erythematous candidosis, Candida-associated lesions.
- Denture stomatitis (Localized simple inflammation, Diffuse erythematous type, Granular type (inflammatory papillary hyperplasia) *, Median rhomboid glossitis (MRG), Angular cheilitis)
- Chronic mucocutaneous candidosis (CMC) (Congenital/Familial CMC, diffuse type, Acquired CMC, focal, or diffuse type, Endocrinopathy associated, Immunosuppression associated)
- Candidiasis endocrinopathy syndrome (CES)
- Chronic candidiasis associated with thymoma
Management of Oral Candidiasis
- Treatment strategies include controlling any local causes, like topical antibiotics.
- Antifungal medications, such as nystatin or amphotericin lozenges, are used to restore normal oral microflora.
- For immunocompromised patients, systemic antifungals like fluconazole or itraconazole could be used.
Important predisposing factors for oral candidiasis
- Immunodeficiency (diabetes mellitus, AIDS, immunosuppression)
- Poor oral hygiene
- Pregnancy
- Anemia
- Antibiotic use (suppressing normal oral flora)
- Xerostomia (dry mouth)
- Hematologic malignancies
- Denture-related irritation or poorly fitting dentures.
Acute Antibiotic-Associated Stomatitis
- Overuse or topical application of antibiotics (like tetracycline).
- Results in suppression of normal oral competing oral flora.
- Marked by generalized oral erythema and soreness.
Denture-Induced Stomatitis
- Asymptomatic erythema confined to the occluded oral mucosa under a well-fitted denture.
- Less irritation is seen under mobile dentures.
- Angular stomatitis can accompany this condition.
Pathology (for different conditions)
- Gram-stained smears may reveal fungal hyphae and yeast forms in oral candidosis.
- Biopsy may show inflammatory infiltrate.
- Periodic acid-Schiff (PAS) stain highlights fungal hyphae.
- Inflammation could be a response to fungal enzymes, like phospholipases.
Denture Treatment
- Denture hygiene is essential.
- Cleansers based on alkaline peroxides, hypochlorites, acids, disinfectants, and enzymes can be used.
- Denture soaks with benzoic acid can help eliminate Candida.
- A protease-containing denture soak effectively removes plaque.
- Chlorhexidine rinse can reduce inflammation.
General management strategies
- Good oral hygiene.
- Removal of heavy candidal plaques through mechanical means.
- Elimination of risk factors is crucial.
- Avoid high sucrose diets.
- Correct ill-fitting dentures or other sources of irritation.
Antifungal Drugs
- Medications including clotrimazole, miconazole, or nystatin, and amphotericin B, are prescribed for mild to moderate cases, typically for 7-14 days.
- Imidazole derivatives (clotrimazole, miconazole) are used topically.
- Systemic therapy (ketoconazole, itraconazole, fluconazole) is an option for severe cases or resistance to topical methods.
Other important points
- Nystatin tablets are better than oral suspension for treating oral candidiasis.
- Treatment duration should be sufficient (at least four weeks).
- Underlying conditions need immediate attention.
- Host defense systems help eradicate candidiasis.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the various infectious oral white lesions, including oral candidiasis and hairy leukoplakia. It highlights the causes, histopathological features, and associations with immune deficiency. Test your knowledge on these important topics in oral pathology.