Alcohol by itself contains known hydrocarbons and nitosamines. A speckled red and white appearance, nonhealing ulceration or induration should signal a priority need for biopsy or referral. The oral manifestations consist of red lesions in the form of petechiae, ecchymoses, or even hematomas, usually located on the palate and buccal mucosa. Thermal burns to the oral mucosa are fairly common, usually due to contact with very hot foods, liquids, or hot metal objects. Some lesions even indicate the precancerous condition. Although white lesions constitute only 5% of oral pathoses, some of these lesions such as leukoplakia, lichen planus, and proliferative verrucous leukoplakia have malignant potential as high as 0. Leukoplakia potentially malignant disorder of oral cavity. Terms commonly used to describe oral lesions fixed a lesion that is nonmobile and firmly attached to the underlying structures mobile a movable lesion that does not appear to be connected to underlying structures indurated hard and firm tissue palpation that would normally be soft exophytic a lesion that appears to be growing outward from the mucosa. The health professional can usually identify them by patient history and clinical xamination. A recent increase in tongue cancer in young females seen 2044 years. If it has been established that the lesions are nonpapillaryverrucous then the first question would be. They vary in size and depth, generally have an irregular outline, and may be solitary or multifocal. Colour of oral mucosa depends on amount and dilatation of blood vessels in the underlying connective tissue degree of keratinisation amount of melanin pigment in.
Thus, prevalence rates should be based on studies of general populations and be stratified by risk factors for the specific lesion. Leukoplakia potentially malignant disorder of oral. The oral cavity or mouth is bounded anteriorly by the lips, posteriorly by the faucial arches just anterior to the tonsils, laterally by the cheeks, superiorly by the palate, and inferiorly by the muscular floor fig. August 4, 2016these lesions must be differentiated from the papillaryverrucous lesions, whose appearance is often white or white and red, is shown in this section and for which there is a different flowchart. About 50% of patients who have oral lesions also present with skin lesions. The duration of white lesions in oral cavity ranged from two weeks to 31 years with a mean of one year two months. These lesions represent a reaction to some kind of chronic trauma or low grade injuries such as fractured tooth, calculus, chewing, and iatrogenic factors including overextended flange of. Oral leukoplakia has been defined in various ways, usually by the characteristics. Pdf on apr 1, 2011, sunil r panat and others published white lesions of the oral mucosaa diagnostic dilemma find, read and cite all the research you. Generalised erythema is great areas of redness in the oral mucosa that could be spread to. Apr 12, 2018 many white lesions involving the oral mucosa are benign and do not require treatment. Differential diagnosis of white lesions of the oral cavity. Ce 110 a guide to clinical differential diagnosis of.
The occurrence of oral mucosal melanoma is the primary reason why all focally pigmented lesions and most diffusely pigmented lesions require a biopsy for diagnosis. Pathological lesions in the oral cavity and oropharynx are highly diverse. Types of white lesions divided based on scrapping off feature. Reactive hyperplasia is the most frequent phenomenon responsible for exophytic lesions in the oral cavity table 1. White mucosal lesions may result from thickening of one or several layers of the oral epithelium. Based on etiology,redandwhitelesionsofthe oralcavitycan be divided into developmental, reactive, infec. Premalignant changes arising in other oral lesions are uncommon.
Refer to this resource when evaluating white and red lesions of the oral cavity. In addition to the white lesion in the oral cavity, pain or burning sensation in the oral cavity was present in 29 58% patients while 16 32% patients had ulcers in the oral cavity. White lesions, such as linea alba, leukoderma, and leukoedema are common in the oral cavity but have no propensity for malignant. Two unrelated patients aged 60 and 61 presented with an asymptomatic, white, slightly raised line on the buccal mucosa. Pigmented lesions of the oral cavity the various lesions and should not be taken as absolute indicator of diagnosis. Oral cavity anatomical and physiological specificities. See tests for oral cavity and oropharyngeal cancers.
The differential diagnosis of abnormalities of the oral cavity will help nondental healthcare providers to refer atrisk patients appropriately for close reexamination. Oral lesions usually arise from autoinoculation, most com. Its defined as a clinical term for a predominantly white lesion of the oral mucosa that cannot be characterized as any other definable lesion. Lecturer in oral pathology, university of queensland. Common superficial oral lesions include candidiasis, recurrent herpes labialis, recurrent aphthous stomatitis, erythema migrans, hairy tongue, and lichen planus. Acute regional trauma or a history of chronic irritation may precede the development of the. Diagnosis of white lesions of the oral mucosa authors. Note a plaque is flatter than a papillaryverrucous lesion. Moreover, although differences in colour can help to differentiate among pigmented lesions, the interpretation of colour can be subjective and is in.
The oral cavity includes the lips, the inside lining of the lips and cheeks buccal mucosa, the teeth, the gums, the front twothirds of the tongue, the floor of the mouth below the tongue, and the bony roof of the mouth hard palate. The treatment of choice is surgical excision, with removal of associated minor salivary glands to. It is the most common malignancy of the oral cavity. Choose from 500 different sets of oral pathology white lesions flashcards on quizlet. The prevalence of many oral lesions depends significantly on individual characteristics. Oral white lesions can be caused by a thickened keratotic layer or an accumulation of nonkeratotic material. Often, the patient is unaware of the habit, so by observing the patient during the.
Mar 21, 2007 oral lesions afflict children and adults, and the pharmacist may be the first point of contact regarding treatment. The oral cavity is defined as the space from the lips to the end of the hard palate. These include congenital or developmental conditions such as white sponge nevus, keratosis follicularis, hereditary benign intraepithelial dyskeratosis, pachyonychia congenita, and fordyce granules. Differential diagnosis of white lesion of oral cavity. Oral ulcers are diagnosed based on the patients history,clinical appearance, site, duration and frequency and the underlying systemic condition furthermore, histopathology also aids in a definitive diagnosis for the majority of ulcerative lesions. To know about common white lesions of oral cavity to differentiate them clinically 3. Pediatric oral pathology 11 dilated excretory duct. Oral surg oral med oral pathol oral radiol endod 2008. White lesions are frequently found during the examination of the oral cavity. After biopsy, residual lesions may be destroyed with a carbon dioxide laser. Differential diagnosis of red lesions of oral cavity.
Verruca vulgaris is a very common childhood infection. Tumors reported to arise in an lp lesion as well as on nonlesional mucosa among. White surface lesions of oral mucosa surface lesions of oral mucosa that appear white, tan, or light yellow are divided into three groups based on their clinical features. Therefore, white lesions mandate an appropriate clinical diagnostic approach to exclude the possibility of malignancy. White lesions of the oral mueosa often present problems of differential diagnosis, whieh are of primary importanee when assessing preeaneerous ehanges in. Truly white oral lesions appear white usually because they are. Multiple white lesions that do not rub off should be noted in patient records, including the location of the lesions.
Red lesions of oral cavity authorstream presentation. Oral l esions can be broadly classified into four different types. White lesions are common findings in the oral cavity. Cancers of the oral cavity and phaynx in the united states. White and red lesions of the oral mucosa maryam jessri, hani mawardi, camile s. August 4, 2016 red lesions these lesions are defined by the change of the mucosa, which turns red. White lesions due to accumulation of necrotic debris on the mucosal surface 3.
Pigmentation in the oral cavity can result from numerous causes table. The oral mucosa is diffusely white, rough, thickened and folded. Wl associated with smokeless tobacco nicotine stomatitis. Differential diagnosis of red lesions of oral cavity dental. Linear white lesion in the oral mucosa jaad case reports. Diagnosis of white lesions of the oral mucosa adkins.
Common sites are the buccal mucosa, lateral border of the tongue, floor of the mouth, and hard palate. Here we can see a list of white lesions which are divided into 2 categories based on their property of being able to scrape of the lesion and a list of lesions which cannot be scrapped off. Pigmented lesions of the oral cavity pocket dentistry. For persistent white or erythematous oral lesions, biopsy should be performed to rule out neo plastic change or cancer. The differential diagnosis of lesions or abnormalities of the. The differential diagnosis of lesions or abnormalities of the oral cavity will help nondental healthcare providers hcps to refer atrisk patients to the appropriate provider so they can be reexamined more closely. Clinical classification of oral lesions is of great importance in the diagnostic process 1, 2. Although some benign physiologic entities may present as white lesions, systemic conditions, infections, and. A white macule is a flat lesion simply reflecting a change of the mucosal colour. Many white lesions involving the oral mucosa are benign and do not require treatment.
These include congenital or developmental conditions. It contains the teeth, the buccal and gingival mucosa, the mandible and hard palate, the floor of the mouth and the tongue anterior to the circumvallate papilla fig. Oral white lesions with special reference to precancerous and tobacco related lesions. Oral melanoacanthoma is a relatively uncommon melanocytic lesion that may cause rapid, diffuse, and dark pigmentation of a large mucosal area. Reactive hyperplastic lesionsinflammatory hyperplasias. Pdf white lesions of the oral mucosaa diagnostic dilemma. The onset of oral white lesions can be acquired or congenital, with a history of longlasting existence in the latter form. The differential diagnosis of lesions or abnormalities of. Oct 29, 2016 the identification of pigmented tissue within the oral cavity may present a diagnostic dilemma for the clinician. The oral cavity structures are mostly under voluntary control. Other areas of the oral cavity such as the ventral surface of the tongue, labial mucosa, soft palate, alveolar mucosa, and floor of the mouth can. Lesions appear white in the oral cavity because the abnormal keratin can reflect the spectrum of light evenly and because of the constant bathing of the hyperkeratotic tissue in saliva, analogous to the appearance of palms and soles when immersed in water for long periods.
One of the keys to improve accuracy in diagnosing oral lesions is forming an appropriate differential diagnosis. Dentistry journal free fulltext oral white lesions. Lesions in the oral cavity generally present as ulcerations, red white lesions, pigmentations, and exophytic lesions. Oral leukoplakia and other white lesions of the oral mucosa related. White lesions such as linea alba, leukoedema, and frictional keratosis are common in the oral cavity but have no propensity for malignant transformation. This article presents the most recent information related to the management of several types of white lesions of the oral cavity. Learn oral pathology white lesions with free interactive flashcards. Oral white lesions preneoplastic actinic cheilitis idiopathic leukoplakia aiman a. White and red lesions of the oral mucosa springerlink. General search engines and specialized databases including pubmed, pubmed central, ebsco, science direct, scopus, embase, and authenticated textbooks were used to find relevant topics by means of mesh keywords such as. Classification of vesiculobullous lesions of oral cavity.
Diagnosis of oral white lesions might be quite challenging. Classification of vesiculobullous lesions of oral cavity pdf. As the list of ulcerative lesions in the oral cavity is quite extensive, the focus here will be. Jul 20, 2016 these lesions must be differentiated from the papillaryverrucous lesions, whose appearance is often white or white and red, is shown in this section and for which there is a different flowchart. Colour of oral mucosa depends on amount and dilatation of blood vessels in the underlying connective tissue degree of keratinisation amount of melanin pigment in epithelium thickness of epithelium 4. Lp is a risk factor for oral cancer in a subpopulation of patients. But other tests may be used first to help determine if they might be cancers and will need a biopsy or to choose the best area to sample for a biopsy. For persistent erythematous or white oral lesions, biopsy should be performed. Common lesions in oral pathology for the general dentist. Whiteappearing lesions of the oral mucosa, obtained their characteristic appearance from the scattering of light through an altered surface, e. Keratotic, white lesions, leukoplakia, mucosa introduction oral white lesions are a common clinical finding in a recent study of more than 17 000 people in the united states, these lesions were found in 27. Ce 110 a guide to clinical differential diagnosis of oral. Lesions of the oral cavity may be associated with disease or sometimes hereditary or even normal.
White surface lesions a guide to clinical differential diagnosis of. White surface lesions a guide to clinical differential diagnosis of oral. Ask the patient about occupational exposures, medications ingested, and familial disorders. The pigment may be focal or diffuse and patchy, but is often regional to the lichenoid lesion fig. Box 1 a systematic approach to the assessment of a suspicious oral mucosal lesion 1. An important feature of all these lesions is the epithelium being intact. Learn vocabulary, terms, and more with flashcards, games, and other study tools. These cancers exhibit even poorer prognosis when they occur in mucosal sites, including within the oral cavity.
The manifestation of mucosal pigment is variable and can range from focal to diffuse macular coloration or from a small nodular growth to a large mass. These tests are described in can oral cavity and oropharyngeal cancers be found early. All patients have oral mucosal lesions which precede skin lesions. Differential diagnosis of white and red lesions of the oral cavity.
Oral white lesions can be caused by a thickened keratotic layer or an accumulation. Hairy leukoplakia hairy tongue dentifriceassociated slough aiman a. White lesions are the pathological changes seen in the oral cavity involving the soft tissues like buccal mucosa, palatal mucosa, tongue and floor of mouth. Among the different forms of lichen planus, the reticular form is the most common and appears as slightly elevated, fine, white lines called wickhams striae, which have a lacelike pattern. Studies of biopsy specimens of white lesions of the oral cavity revealed a 2% to 4% incidence of dyskeratosis. Farah, and sookbin woo abstract there are several conditions that can present as white or red macular, papular, andor plaquelike lesions of the oral mucosa.
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