Sandbox:Affan: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 181: Line 181:
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
|-
|-
| rowspan="12" |Pigmented lesions
| rowspan="11" |Pigmented lesions
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Ephelis
* Ephelis
Line 357: Line 357:
|
|
* Curvilinear trabeculae of metaplastic woven bone in hypocellular, fibroblastic stroma
* Curvilinear trabeculae of metaplastic woven bone in hypocellular, fibroblastic stroma
|
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Medication induced pigmentation
|
|
|
|
|
|
|-
|-

Revision as of 19:54, 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
  • Increased melanin pigmentation is noted in the basal cell layer of the epithelium.
  • Melanin incontinence may also be noted in the underlying lamina propria
  • Melanoma
  • Varies from dark brown to blue-black
  • Mucosa-colored and white lesions are occasionally noted
  • Erythema is observed when the lesions are inflamed.
  • Idiopathic
  • 80% cases involve palate and maxillary gingiva
  • Buccal mucosa, mandibular gingiva, and tongue lesions
  • Acral lentiginous
  • Malignant cells often nest or cluster in groups in an organoid fashion
  • Kaposi sarcoma
  • HIV and HHV-8.
  • Hard palate is most frequently affected, followed by the gums
  • Addison's disease
  • Hyperparakeratinized areas showing acanthosis, spongiosis, exocytosis, vacuolar degeneration,
  • Substantial deposition of melanin in all epithelial layers
  • Melanocytic hyperplasia
  • Dendritic melanocytes in all epithelial layers.
  • Peutz jeghers syndrome

Perioral

  • Freckling of the skin around lips and vermillionzone of the lips.

Intraorally

  • Neurofibromatosis
  • Proliferation of all elements of peripheral nerves
  • Schwann cells with wire like collagen fibrils,fibroblasts and collagen
  • Perineurial cells in plexiform types, mitotic figures are rare
  • Polyostotic fibrous dysplasia
  • Orofacial deformity
  • Dental disorders
  • Bone pains
  • Compromised oral health
  • Predominantly involves musculo-skeletal defects of oral cavity
  • Gingiva
  • Curvilinear trabeculae of metaplastic woven bone in hypocellular, fibroblastic stroma
  • Amalgam tattoo
  • Pigmented fragments of metal within connective tissue
  • A scattered arrangement of black or dark brown granules
  • Large particles may be surrounded by chronically inflamed fibrous tissue
Oral lesions Characteristic features Associated conditions Location Microscopic Image
Vesicular/

Ulcerative

Infections Herpes simplex virusinfections

Herpetic gingivostomatitis

  • Painful ulcers covered by a yellowish pseudomembrane
  • Ulcers that may coalesce to form bigger lesions
  • Self limiting after 7 days
  • HSV 1 Infection
Herpes zoster
  • Clustered small ulcers with characteristic unilateral pattern
Hand foot mouth disease
  • Oval-shaped, pale papules with a rim of erythema
  • Small aphthae
Infectious mononucliosis
Erosive lichen planus
Pseudomembranous candidiasis

Insert paragraph

  • Known as thrush.
  • Usually asymptomatic.
  • Confluent white wipeable plaques resembling curdled milk
  • Superficially the plaques can be wiped off and the underlying mucosa often exhibits an erythematous appearance.
Histoplasmosis
  • Ohio and Mississippi river valleys
Blastomycosis
  • Mississippi, Missouri and Ohio River valleys and the Great lakes region.
Coccidiodomycosis
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