Surface oral lesions
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Oral lesions
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Appearance
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Associated conditions
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Location
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Microscopic
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Image
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White Lesions
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Leukoedema
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- White or whitish grey edematous lesion
- Diffuse or patchy
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- Variant of normal oral mucosa
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- Buccal and labial oral mucosa
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- Intracellular edema or vacuolization of Malpighian cells.
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Fordyce granules
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- White or yellow discrete papules
- Symmetrically distributed
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- Variant of normal oral mucosa
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- Buccal mucosa
- Vermillion border of the lips
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- Similar to normal sebaceous glands of skin
- Lacks hair follicles and almost always lack ductal communication with surface.
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Benign migratoy glossitis
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- Red patches with white distinct border
- Map like appearance
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- Psoriasis
- Diabetes
- Reiter's syndrome
- Medications such as Oral contraceptive pills and lithium carbonate
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- Dorsal/Lateral surface of the tongue
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- Acanthosis with neutrophils throughout epithelium and surface
- Microabscesses, plus inflammatory infiltrate in lamina propria
- Resembles psoriasis
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Hairy tongue
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- Elongated filliform lingual papillae
- Carpet like appearance
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- Xerostomia
- Medications such as anti-psychotics
- HIV
- Amyotropic lateral sclerosis
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- Marked elongation and hyperparakeratosis of the filiform papillae
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Hairy leukoplakia
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White patches
- Corrugated in appearance
- Hairy, hair-like growths
- Permanent
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- Buccal mucosa
- Lateral surface of the tongue
- Floor of the mouth
- Palate
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- Hyperkeratotic oral mucosa due to piling of keratotic squamous epithelium
- Cowdry type A intranuclear inclusions
- Balloon cells with margination of chromatin
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White sponge nevus
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- White patches of tissue (nevi)
- Singular or multiple
- Thickened, velvety, sponge-like appearance
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- Parakeratosis, acanthosis
- Extensive vacuolation
- Dyskeratotic cells exhibit dense peri and paranuclear eosinophilic condensations
- Abundant Odland bodies
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Lichen Planus
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- Reticular or papular lace like white lesions
- Multiple, Painful
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- Autoimmune disorders disorders
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- Posterior buccal mucosa
- Gingival margin
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- Hyperkeratosis and acanthosis
- Granular cell layer, sawtoothing of rete pegs, bandlike chronic inflammatory infiltrate
- Civatte bodies
- Artifactual cleft formation
- No atypia
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Frictional hyperkeratosis
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- White shaggy plaques
- Could be easily peeled without any pain leaving normal mucosa
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- Bite trauma
- Grinding of the teeth
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- Buccal mucosa
- Limited to line of dental occlusion
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- Hyperkeratinization and acanthosis
- Smooth, corrugated, or ragged, epthelial surfac with multiple keratin projections
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Leukoplakia
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- 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
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- Soft palate
- Floor of mouth
- Ventral surface of tongue and the retromolar area
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- Varies histologically from acanthosis, hyperkeratosis, dysplasia or carcinoma in situ
- Carcinoma in situ is associated with lymphocytes and macrophages
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Erythroplakia
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- Fiery red patch
- Smooth, velvety, granular or nodular lesions
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- Highest risk of malignant transformation
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- Soft palate
- Floor of mouth
- Ventral surface of tongue and the retromolar area
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- Thin atrophic epithelium with prominent subepithelial vascularity and inflammation.
- Almost all erythroplakic lesions contain dysplastic cells
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Oral lesions
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Characterestic features
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Associated conditions
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Location
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Microscopic
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Image
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Pigmented lesions
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- Flat red or light brown spots
- 3–10 mm in diameter
- Poorly defined and may merge into large patches
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- Predominant in outer lips
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- Mild hyperpigmentation of basal keratinocytes, normal architecture
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- Focal pigmented brown lesions similar to ephelides
- Flat and mostly smaller than 1 cm
- Characterised by a focal increase in melanin production
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- Gingiva, with the buccal mucosa and palate
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- No atypia.
- Melanin pigmentation tends to be present in significant amounts in the basal-cell layer.
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- Polyostotic fibrous dysplasia
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- Medication induced pigmentation
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Vesicular/Ulcerative oral lesions
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Symptoms
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characterestic features
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Associated conditions
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Location
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Image
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Infections
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Autoimmune conditions
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Idiopathic conditions
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