Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Red and White Lesions of the Oral Mucosa

No description
by

Hsuan Han

on 16 April 2015

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Red and White Lesions of the Oral Mucosa

Red
Lesions

White
Lesions

Intraoral color change
Red
and
White
Lesions of the Oral Mucosa

Solitary Red Lesions
Generalized Red Conditions and Multiple Ulcerations
Behçet's Disease
Outline
Red
Vascular dilatation
Extravasation of blood
Arophy or Erosion
Increasing hemoglobin
Infection
Allergy
Hemostatic Disease
Cancer associated lesion
Inflammatory Hyperplasia
Chemical or Thermal erythematous macules
White
Red
&
White

Yellow
Pigment
Red condition of the Tongue
Normal Mucosa
healthy mucosa:

light pink
Trauma
Candidiasis
Intraoral
color

changes
Red Lesions
White

Lesions
Low-grade
insult. (usually chronic)
Frank ulcer
Cause
Brief trauma
Feature
Usual site
Anterior and lateral boarder of tongue
Mouth floor
Posterior palate
Buccal mucosa
Lip
Various
Size
Shape
Color
Symptoms
Regresses
Quickly

ill-fitting prosthetic
sharp margin of teeth
Biting
Management
Differential Diagnosis
Traumatic erythematous macules
purpuric macules of oral sex
palate bruising
macule hmangioma
atrophic candidiasis
mononucleosis
herpangina
Painless
Painless

Painless
Painless
Blanch
Blanch
Transient

Transient
Remove the mechanical irritants
Make sure the lesion disappeared
Traumatic erythematous macules and erosions
Red papillary hyperplasia
Biopsy
Cause
List of diseases
pyogenic granuloma
hormonal tumor
traumatic hemangioma
epulis fissuratum
epulis granulomatosum
inflammatory fibrous hyperplasia
papillary hyperplasia
parulis
peripheral giant cell grauloma
peripheral fibroma with calaification
chronic irritants
Features
Quite
Red
moderately soft
Polypoid or nodular mass
Properties
Differential Diagnosis
Hemangioma
Metastatic tumor
Primary malignant tumor
Karposi sarcoma
Papilloma/condyloma/verruca
The early IH lesion Must be differential diagnosis from
Irritants usually identifiable
History taking is important
adjacent to bony changes
irritants not apparent
present from birth
History taking is important
cauliflower-like surface
Management
Remove irritants
Low Suspicion Index
High suspicion Index
External biopsy
chemical burn
thermal burn
Caused
Tender to painful
may blanch on pressure
slight bleeding
hot food
drug
Feature
Differential diagnosis
Buccal and palatal mucosa are most common sites
erythematous macule form mechanical trauma
purpuric macule
allergic manifestations
cellulitis
erythroplakia
atrophic candidiasis
fungal infection
herald spot of disseminated red conditions
Recent History of Thermal or Chemical Injuries
Management
Analgesics and topical applications
dexaltin
Surveillance when the diagnosis is uncertain
biopsy when the lesion does not resolve promptly
Erythematous candidiasis
Angular cheitlitis
Candida: common harmless yeast
Features
Clinical lesion
pseudomembranous
erythematous
atrophic
hyperplastic
mixed
mucocutaneous
esophagitis and other
Atrophic/ Erythematous Candidiasis
Denture Stomatitis
Angular cheilitis
Single lesion or generalized mucositis
Atrophic/Erythematous/Mixed
Tenderness, burning, pain are usual sypmtoms
Minor bleeding might observed
Some blanch on pressure
Cause
ill-fitting denture
Inflammatory reactions
Risk factors
smoking
Continual wearing of denture
Denture trauma
Plaque
Candida
tissue invasion by organism
effect of fungal toxin
hypersensitive to the fungus, bacteria or carboxylic acid produced by microflora of the denture plaque
Reddish ulcerative condition spreading form the corners of mouth
(bilateral)
Factors
decreased VD
iron deficiency anemia
vitamin B deficiency
fungus/bacteria infection
Differential diagnosis and Management
Seldom diseases appeared like denture stomatits
Contact allergy to acrylic: redness will not restricted to tissue under the denture.
Management
correct denture faults
antifungal therapy
improving oral hegiene
contact allergy to denture
Allergic macules
Appearance
erythema
erosion
Cause
gold alloy
silver amalgam
rubber products
eugenol
orthodontic wire
cinnamon
Differential diagnosis
traumatic erythemas
physical or chemical burn
erythroplakia
macular hemangiona
ecchymosis
localized candidiasis
single red lesion of contact allergy
Congenital Defect
Hemangioma
Erythroplakia
Red macular SCC
Features
Velvety red
granular red
slightly raised
painless
appearance
hemogeneous: completely red
patches of erythroplakia and leukoplakia
Type
speckled erythroplakia
various in size and boarder type
Most common sites
mouth floor
mandible sulcus
retromolar region
Precancerous red conditions
Differential diagnosis
traumatic erythema
Atrophic candidiasis
Purpuric macule(early stage)
Macular hemangoima
Contact allergy
Other infection
Localized gingivitis
Karposi sarcoma
Transient
Transient
Transient


Transient
EP on gingiva may be overlooked
Management
Lesion last more than
14 days
Moderate to high suspicion index
Biopsy
Exophytic SCC
Exophytic Squamous Cell Carcinoma
Mass arising in covering epithelial surface as a
rough contour and surface
Surface of the lesion may various in roughness
form lesion to lesion
and
from area to area
on the same lesion
Differential diagnosis
IH
papilloma/condyloma
hemangiomas
karposi's sarcoma
other malignancies
Erosive Lichen Planus
Pemphigus
Disquamative gingivitis
Allergy
Lupus Erythematosus
pamphigus vulgaris
Management
Corticosteroid therapy
alternate-day steroid and gold therapy
Immunosuppressive treatment
Features
Recurrent aphthous mucositis
oral
genital
skin
arthritic
Neuro-ocular symptom
eyes
Differential diagnosis
Vesicles and blebs healing in 7 to 14 days
Well-defined circumscribe
benign mucous membrane pemphigoid
pemphigus
erythema multiforme
lichen plenus
lupus erythematosus
Features
Burning sensation
Pain
granular surface
bleeding when trauma
Patterns change week form week
reticular feathery pattern
lacy pattern
Women in 4th to 5th decade
Keratotic white entities
leukoedema
Leukoplakia
Nicotine stomatitis
Appearance
Management
Appearance
Symptom
Migratory glossitis
Median rhomboid glossitis
Lugwid's angina
Parulis
Pericoronitis
Odontogentic infection
Features
Most frequent site
alveolar mucosa
gingiva
Appearance
pain
swelling
hot
red
tender
pus formation
fluctuant to touch
Differential diagnosis
Reddish painful swelling
tender cervical lyphadenitis
+
History taking
Clinical exam
X-ray
Pulp test
Management
Acute cases
Normal cases
Airway was threatened
Eliminate the association dental problem
Amoxicillin
Hospitalize
Telangiectasia
Hemangioma and Telangiectasia
Features
Long duration
No inflammatory component
No tenderness
Blanch on pressure
Management
Conscientious observe
Radiation
Steroid
Embolization
Sclerosing solutions
Antimetabolites
Surgical removal
Red purpuric macule
5-ASA derivatives
sulfasalazine /mesalamine
systemic corticosteroids
azathioprine
tumor necrosis factor-α antagonists
thalidomide
"Geographic tongue"
no symptoms
pain
burning
when eating hot, acidic or spicy
The cause is unknown
Median rhomboid glossitis
, MRG, also known as
central papillary atrophy
, or
glossal central papillary atrophy
no symptoms
Cause factors
smoking
denture wearing
use of corticosteroid sprays or inhalers
HIV infection
Candida
bacteria
Usually the mucosal changes resolve with antifungal therapy, but sometimes the lesion is resistant to complete resolution.
Treatment
Features
Int. Hsuan Han
Full transcript