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* No atypia.  
* No atypia.  
* Melanin pigmentation tends to be present in significant amounts in the basal-cell layer.
* Melanin pigmentation tends to be present in significant amounts in the basal-cell layer.
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* Proliferation of benign dendritic melanocytes scattered throughout the epithelium, acanthosis and spongiosis
* Proliferation of benign dendritic melanocytes scattered throughout the epithelium, acanthosis and spongiosis
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Revision as of 17:40, 11 February 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Muhammad Affan M.D.[2]

Surface oral lesions
Oral lesions Appearance Associated conditions Location Microscopic Image
White Lesions Leukoedema
  • White or whitish grey edematous lesion
  • Diffuse or patchy
  • Variant of normal oral mucosa
  • Buccal and labial oral mucosa
  • Intracellular edema or vacuolization of Malpighian cells.
Fordyce granules
  • White or yellow discrete papules
  • Symmetrically distributed
  • Variant of normal oral mucosa
  • Buccal mucosa
  • Vermillion border of the lips
  • Similar to normal sebaceous glands of skin
  • Lacks hair follicles and almost always lack ductal communication with surface.
Benign migratoy glossitis
  • Red patches with white distinct border
  • Map like appearance
  • Psoriasis
  • Diabetes
  • Reiter's syndrome
  • Medications such as Oral contraceptive pills and lithium carbonate
  • Dorsal/Lateral surface of the tongue
  • Acanthosis with neutrophils throughout epithelium and surface
  • Microabscesses, plus inflammatory infiltrate in lamina propria
  • Resembles psoriasis
Hairy tongue
  • Elongated filliform lingual papillae
  • Carpet like appearance
  • Xerostomia
  • Medications such as anti-psychotics
  • HIV
  • Amyotropic lateral sclerosis
  • Dorsum of the tongue
  • Marked elongation and hyperparakeratosis of the filiform papillae
Hairy leukoplakia

White patches

  • Corrugated in appearance
  • Hairy, hair-like growths
  • Permanent
  • Buccal mucosa
  • Lateral surface of the tongue
  • Floor of the mouth
  • Palate
  • Hyperkeratotic oral mucosa due to piling of keratotic squamous epithelium
  • Cowdry type A intranuclear inclusions
  • Balloon cells with margination of chromatin
White sponge nevus
  • White patches of tissue (nevi)
  • Singular or multiple
  • Thickened, velvety, sponge-like appearance
  • Heriditarary
  • Buccal mucosa
  • Parakeratosis, acanthosis
  • Extensive vacuolation
  • Dyskeratotic cells exhibit dense peri and paranuclear eosinophilic condensations
  • Abundant Odland bodies
Lichen Planus
  • Reticular or papular lace like white lesions
  • Multiple, Painful
  • Autoimmune disorders disorders
  • Posterior buccal mucosa
  • Gingival margin
  • Hyperkeratosis and acanthosis
  • Granular cell layer, sawtoothing of rete pegs, bandlike chronic inflammatory infiltrate
  • Civatte bodies
  • Artifactual cleft formation
  • No atypia
Frictional hyperkeratosis
  • White shaggy plaques
  • Could be easily peeled without any pain leaving normal mucosa
  • Bite trauma
  • Grinding of the teeth
  • Buccal mucosa
  • Limited to line of dental occlusion
  • Hyperkeratinization and acanthosis
  • Smooth, corrugated, or ragged, epthelial surfac with multiple keratin projections
Leukoplakia
  • White or grayish in patches that can't be wiped away
  • Irregular or flat-textured
  • Thickened or hardened in areas
  • Along with raised, red lesions (speckled leukoplakia or erythroplakia), which are more likely to show precancerous changes
  • Smoking
  • Soft palate
  • Floor of mouth
  • Ventral surface of tongue and the retromolar area
  • Varies histologically from acanthosis, hyperkeratosis, dysplasia or carcinoma in situ
  • Carcinoma in situ is associated with lymphocytes and macrophages
Erythroplakia
  • Fiery red patch
    • Smooth, velvety, granular or nodular lesions
  • Highest risk of malignant transformation
  • Soft palate
  • Floor of mouth
  • Ventral surface of tongue and the retromolar area
  • Thin atrophic epithelium with prominent subepithelial vascularity and inflammation.
  • Almost all erythroplakic lesions contain dysplastic cells
Oral lesions Characterestic features Associated conditions Location Microscopic Image
Pigmented lesions
  • Ephelis
  • Flat red or light brown spots
  • 3–10 mm in diameter
  • Poorly defined and may merge into large patches
  • Sun exposed skin
  • Predominant in outer lips
  • Mild hyperpigmentation of basal keratinocytes, normal architecture
  • Oral melanocytic macule
  • Focal pigmented brown lesions similar to ephelides
  • Flat and mostly smaller than 1 cm
  • Characterised by a focal increase in melanin production
  • Idiopathic
  • Gingiva, with the buccal mucosa and palate
  • No atypia.
  • Melanin pigmentation tends to be present in significant amounts in the basal-cell layer.
  • Oral melanoacanthoma
  • Proliferation of benign dendritic melanocytes scattered throughout the epithelium, acanthosis and spongiosis
  • Smoker's melanosis
  • Melanoma
  • Kaposi sarcoma
  • Addison's disease
  • Peutz jeghers syndrome
  • Neurofibromatosis
  • Polyostotic fibrous dysplasia
  • Medication induced pigmentation
  • Amalgam tattoo
Vesicular/Ulcerative oral lesions Symptoms characterestic features Associated conditions Location Image
Infections
Autoimmune conditions
Idiopathic conditions
Soft tissue oral lesions
Reactive lesions Symptoms Characterstic features Associated conditions Location Image
  • Leukoedema
  • Fordyce granules
  • Hairy tongue
  • Hairy leukoplakia
  • White sponge nevus
  • Lichen planus
  • Focal keratosis
Tumors etiology location Clinical appearance Gold standard/Diagnosis Image
Benign tumors
  • Epithelial tumors
  • Mesenchymal tumors
  • Salivary gland tumors
Malignant tumors
Cysts
  • Gingival cyst
  • Lymphoepithelial cyst
  • Epidermoid cyst
  • Thyroglossal tract cyst
  • Nasolabial cyst

References