Practitioners will see many oral white lesions but few carcinomas. Some of these pseudolesions can simulate oral potentially malignant lesions, vascular abnormalities, infective and autoimmune diseases, or. Red lesions of oral cavity authorstream presentation. Suggestion for a classification iria gomez 1, pablo varela, amparo romero, maria jose garcia 2, maria mercedes suarez 1, juan seoane 1. Pigmented lesions commonly seen in the oral cavity represent a variety of clinical entities, ranging from normal physiologic changes to clinical manifestations of systemic illnesses and malignant. Generally, the clinical aspects of pigmented lesions in the oral cavity are sufficient in establishing the diagnosis. The simple fibroma occurs with considerable frequency in tlic oral cavity. Box 1 a systematic approach to the assessment of a suspicious oral mucosal lesion 1. In addition, both benign and malignant lesions can be seen. Oct 29, 2016 the identification of pigmented tissue within the oral cavity may present a diagnostic dilemma for the clinician. Among the diseases of oral mucosa, malignant tumors are the most dangerous, but not the most common lesions that might appear in the oral.
Pigmentation varies widely and may be present in a generalized fashion throughout the oral cavity or as an isolated focal lesion. Differential diagnosis image by tom mooring differential diagnosis chemical burn, traumatic lesions, herpes simplex, aphthous ulcers, drug reactions. Mar 23, 2014 miscellaneous lesions of oral cavity and tongue median rhomboid glossitis red rhomboid area, devoid of papillae, seen on the dorsum of tongue in front of foramen caecum. Synthesis of melanin starting with the aminoacid tyrosine, which, with the enzyme tyrosinase, is a fundamental prerequisite, the successive steps in.
A 59yearold man presented with multiple painful ulcers in the oral cavity. They are classified as generalized lesions, which are diffuse and multifocal, and localized lesions, which are unilateral and involve only one or several locations. However, the lesion often responds to antifungal treatment with nystatin, fluconazole, or clotrimazole as a suspension or. The differential diagnosis of lesions or abnormalities of.
Benign soft tissue lesions of oral cavity sis of the lesions. Benign inflammatory lesionsconditions of oral mucous. Differential diagnosis of white lesion of oral cavity. Thermal burns to the oral mucosa are fairly common, usually due to contact with very hot foods, liquids, or hot metal objects.
To determine the types and relative frequency of the oral cavity lesions, and to assess their age, sex, and site distribution. Melanotic macules are the most common oral mucosal lesions of melanocytic origin. A speckled red and white appearance, nonhealing ulceration or induration should signal a priority need for biopsy or referral. Oral squamous cell carcinoma clinically presents with indurated margins. A guide to descriptive terminology learning outcomes. Pigmented lesions of the oral cavity the various lesions and should not be taken as absolute indicator of diagnosis.
An important feature of all these lesions is the epithelium being intact. 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. Diseases of oral cavity is the property of its rightful owner. These color changes often occur due to deposition,production or increased accumulation of various endogenous or exogenous pigmented substances. Lesion are inherited as an autosomal dominant condition. The most common pigmented lesions are in the cheek, and amalgam tattoos are the most frequent pigmented lesions reported. Epidemiology of oral mucosal lesions in slovenia ncbi. Traumatic erythema occurs when a traumatic effect results in hemorrhage within the oral tissues. Multiple white lesions that do not rub off should be noted in patient records, including the location of the lesions. Dentists look for abnormal changes that are loosely called lesions. Elevate confidence in documentation of an oral lesion recognize clinical characteristics which determine descriptive terminology understand the role of the dental hygienist in the pathway to clinical management of an abnormal finding.
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. Lesions of oral soft tissues in children pedo mouth. Introduction the oral cavity represents one of the most anatomically diverse regions within the head and neck. 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. White lesions caused by biting generally occur along the occlusal line. Evaluation of a suspicious oral mucosal lesion canadian dental. The oral cavity is vulnerable to a limitless number of environmental insults because of its exposure to the external world.
Leukoedema is a common normal variation of the oral mucosa. However they must be able to recognize lesions at particular risk and several features which. Oral lichenoid lesions can be a diagnostic challenge for the pathologist due to the tremendous overlap in the clinical and pathologic presentation of many inflammatory, reactive, and immune mediated disorders than commonly involve the oral mucosa. These cancers exhibit even poorer prognosis when they occur in mucosal sites, including within the oral cavity. Apr 12, 2018 many white lesions involving the oral mucosa are benign and do not require treatment. White lesions are common findings in the oral cavity. Any mucosal site may be affected but the lower lip, gingiva and palate are the most common areas.
Recurrent aphthous stomatitis ras is one of the most common and painful conditions in the oral cavity. The most common types of nevi found are intramucosal 40. Many lesions are innocuous and can be easily diagnosed and named based upon their appearance alone. Oral melanoma and other pigmented lesions of the oral cavity. Hairy leukoplakia hairy tongue dentifriceassociated slough aiman a. Studies about the prevalence of these lesions in the oral cavity are scarce. The oral cavity represents one of the most anatomically diverse regions within the. This chapter discusses the etiology and presentation of pigmented lesions as well as certain systemic conditions associated with oral pigmentation. If it is single, look for local sources of irritation, such as cheek, tongue or lip biting. Diagnosis of white lesions of the oral mucosa adkins. Pigmented surface lesions of oral mucosa appear blue, brown, or black. The differential diagnosis of lesions or abnormalities of the oral cavity will help non dental healthcare providers hcps to refer atrisk patients to the appropriate provider so they can be reexamined more closely. The treatment of these lesions is, in the most of cases, surgical excision, also for histological examination.
Oct 31, 2018 oral cavity cancer accounts for approximately 3% of all malignancies and is a significant worldwide health problem. This chapter provides a brief introduction in to oral medicine, and signposts to those dermatological conditions that can be associated with oral lesions. Oral cavity anatomical and physiological specificities. 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. Introduction various premalignant lesions, particularly red lesions and some white lesions have a potential for malignant change.
Ppt diseases of oral cavity powerpoint presentation. If so, share your ppt presentation slides online with. To download additional copies of this brochure, go to. Many white lesions involving the oral mucosa are benign and do not require treatment. The management of oral lesions generally falls outside the remit of this website as such conditions are often managed by oral and maxillofacial surgeons. Identify the effect of nerve paralysis on those muscles and their related function 4. Aug 15, 20 these cancers exhibit even poorer prognosis when they occur in mucosal sites, including within the oral cavity. Generalised erythema is great areas of redness in the oral mucosa that could be spread to. The excessive use of tobacco products has been associated with various lesions in the oral cavity. Pigmented surface lesions of oral mucosa ce110 dentalcare. Although variable, the lesions typically begin in childhood or adolescence, occur more frequently in females and tend to be seen less often in adults over 40.
Seen most frequently in older females and not associated with smoking. Wl associated with smokeless tobacco nicotine stomatitis. A routine part of an oral examination should be inspection not only of the teeth and gums but also of the soft tissues in and around the mouth. Oral melanotic macule and labial melanotic mac ule are terms that now appear in standard oral pa volume 24 number 4 april 1991 melanoma and other pigmented lesions of the oral cavity 533 thology textbooks but have not been generally rec ognized by dermatologists, as evidenced by their scarcity in dermatologic journals and textbooks.
These small, solitary, wellcircumscribed and often uniformly pigmented lesions develop most commonly in adult female patients. Differentiate different parts of the oral cavity 2. These patients are at an increased risk of developing a carcinoma. Introduction cancers of the oral cavity and oropharynx represent approximately three percent of all malignancies in men and two percent of all malignancies in women. In the oral cavity, endogenous and exogenous pigment deposits reflecting a variety of systemic and local processes may be found. The prevalence of oral mucosal lesions in the patients visiting a. Lecture presented to the queensland branch of the australian dental association, october, 1965. Differential diagnosis of white lesions of the oral cavity evaluate the mouth to see if the white lesion is single or multiple. Choose from 500 different sets of oral lesions cancer flashcards on quizlet. However they must be able to recognize lesions at particular risk and several features which help to assess the likelihood of malignant transformation. August 4, 2016 red lesions these lesions are defined by the change of the mucosa, which turns red. Reference to a location in the oral cavity or proximity to dentition for example, lesion is located 2 mm. Differential diagnosis of red lesions of oral cavity.
Early biopsy of oral pigmented lesions that are focal and of undetermined etiology is required to detect oral melanomas at an early stage. Many systemic conditions appear initially in the oral cavity and prompt diagnosis and management can help in minimizing disease progression and organ destruction. 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. Biopsy is necessary for definitive diagnosis treatment. 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. Various premalignant lesions, particularly red lesions and some white lesions have a potential for malignant change.
Oral white lesions preneoplastic actinic cheilitis idiopathic leukoplakia aiman a. Describe the blood and nerve supply of mucosa and muscles of palate and tongue 3. As the term implies, these lesions have the color of coffee with cream and vary from small ephelislike macules to broad diffuse lesions. Dentists who encounter a change in the oral mucosa of a patient must decide whether the abnormality. Oral cavity cancer accounts for approximately 3% of all malignancies and is a significant worldwide health problem. Pigmented lesions of the oral cavity pocket dentistry. Pattern of oral cavity lesion international journal of. The management of oral lesions generally falls outside the remit of this website as such conditions are often managed by. Pigmented lesions of oral mucosa oral and perioral pigmentation may be physiologic or pathologic in origin. However, the lesion often responds to antifungal treatment with nystatin, fluconazole, or clotrimazole as a suspension or oral troches. These include congenital or developmental conditions such as white sponge nevus, keratosis follicularis, hereditary benign intraepithelial dyskeratosis, pachyonychia congenita, and fordyce granules. She was noted to have hyperpigmented brown macules on the inner surface of the lower lip and buccal mucosa figure 1. Differential diagnosis of red lesion of oral cavity by.
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. Note that some soft tissue enlargements are pigmented, but they are discussed under soft tissue enlargements. Thus, regardless of the cause, the early recognition and evaluation of pigmentation in the oral cavity can result in improved prognoses for patients with. However, in some cases, biopsy is necessary and occasionally, immunohistochemical stains such as melanocyte marker hmb45 and macrophage marker cd68 may be required to prompt a correct diagnosis. Learn oral lesions cancer with free interactive flashcards.
If it has been established that the lesions are non papillaryverrucous then the first question would be. An overweight woman, aged 58 years, presented for follow up of hypertension, diabetes and dyslipidaemia. Oral melanoacanthoma is a very rare diffuse pigmentation with no specific treatment required. The most commonly affected site is the buccal mucosa along the line of occlusion. If you continue browsing the site, you agree to the use of cookies on this website. The differential diagnosis of lesions or abnormalities of the. Elevated lesions nonblisterform not containing fluid nodule a solid mass visible or palpable within or underneath the mucosa papule a welldefined elevated lesion lesion is necessary in most of the cases in the oral cavity. Based on the histopathological descriptions available in the reports these oral tumours were grouped under the four categories of benign epithelial lesions, soft tissue tumors, minor salivary gland tumors and tu. The identification of pigmented tissue within the oral cavity may present a diagnostic dilemma for the clinician.
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