Advertisement Upgrade to remove ads

Congenital Hemangiomas -present at birth -vascular proliferation -capillary and cavernous clinical features -middle aged and older population -also known as strawberry nevus "stork bit" -present at time of birth, but may not be apparent until early childhood -red toblue -blanch when compressed -No thrill ot bruit -lip, tongue, buccal mucosa -may undergo spontaneous involution -often circumscribed, rarely affects bone

Congenital Vascular Malformations

Persistant lesions that grow with individuals and do not involute
-mix of arteries, vein, and capillaries
-grows with patient
-Poorly circumscribed, may affect bone
-thrill and bruit
-does not involute
-difficult to resect
-recurrence common

Encephalotrigeminal Angiomatosis

Sturge-Weber Syndrome
> Port-wine stain, a facial lesion, involved skin innervated by one or more of trigeminal nerve
> Vascular maliformation
> Leptomeninges of cerebral cortex of face
> May involve buccal mucosa and gingiva
> Mental retardation, hemiparesis, seizure disorder

Hereditary Hemorrhagic Telangiectsia

-dilaceration of veins
- Rendu-Osler- Weber Syndrome
-rare
-autosomal dominant
-red macules= abnormal vascular dilationsof terminal vessels in skin, mucous membranes
-Epitaxis ( bleeding from ear), bleeding from oral lesions

Congenital Hemangiomas

-Capillary
-Cavernous
> if central in bone ( maxilla or mandile) appear a radiolucent lesion with a honey comb pattern and distinct margin

Treatment
> may involute spontaneously
> Surgery, arterial embolization, sclerosant therapy, laser

Venous Varix

Focal dilation of single vein
-commonly seen ventral surface tongue (underneath)
-lower lip of older patient
-varices are blue and blanch with compression
Treatment= None

Pyogenic Granuloma

Part of the Big Three
Exuberant connective tissue proliferation to a known stimulus or injury
- red color because hyperplastic granulation tissue (multiple capillaries)
"Pregnancy tumor"
-Clinical features
> attached gingiva usually
> caused by calculus or foreign material
> Hormonal changes

-also seen on lower lip, tongue, buccal mucosa
-ulcerated lesion may be covered with yellow, fibrinous membrane
Size= few mm to several cm
Any age
More common in females
Treatment =surgical excision biopsy

Peripheral Gait Cell Granuloma

Part of the Big Three
-Hyperplastic connective tissue response to injury to gingival tissue
-Reactive hyperplastic
-attached gingiva
-Has multinucleated gaint cells
Clinical features
>red to blue, broad based masses
> B/t permanent molars and incisors
Size=1cm
-any age
-more common in females
-may cause underlying bone resorption
"Peripheral- cuff" radiolucency
-Histologically is identical to the central gaint cell granuloma and brown tumor of hyperoarathyriodism
> recurrence common b/c deep seated

Scarlet Fever

-Systemic bacterial infection
-Erythrogenic toxin causes capillary damage (group A streptococci)
-spread by droplet infection
-Chlidren (crowded conditions)
Clincally
> Pharyngitis, tonsillitis, fever, lymphadenopathy, malaise, headache
> red rash on chest
> strawberry tongue
Treatment= penicillin (to help prevent complications of rheumatic fever and glomerulonephritis)-kidney problems

Erythroplakia

Red patch on oral mucous membrane
-Most are found to be severe dysplasia or carcinoma(91%) bad
-causes include tobacco, alcohol, nutritional defects, etc.
-seen much less commonly than leukoplakia(1:26)
1 red/ 26 white
-age 50-70

High risk sites=floor of the mouth, tongue, retromolar mucosa
DD: Kaposi's sarcoma, ecchymosis, contact allergic reaction, vascular maliformation, psoriasis

Treatment=surgical excisional biopsy
-It is generally accepted that severely dysplasticand in situ lesions eventually become invasive

Kaposi's Sarcoma

-Proliferation of endothelial cell origin
-Human herpes virus 8 (HHV8)
Clinically
> multifocal reddish brown nodules primarily in the skinof lower extremities
Oral=palate, gingiva, tongue
> flat lesions to nodular exophytic lesions
> red and blue
-about 1/2 of AIDS affected patients with cutaneous Kaposi's sacroma develop oral lesions

DD: Hemangioma, erythroplakia, melanoma, pyogenic granuloma
Treatment= surgery, lower dose radiation, chemotherapy

Vitamin B Deficiencies

-See in poor socioeconomic conditions
-Also with GI disease, alcoholism, starvation, fab diets

Oral=cheilitis and glossitis
> Angular cheilitis
> Tongue reddened, with atrophy of papillea, and pain and burn
-Niacin=for D"S
> Dermatitis, diarrhea, dementia, death

Treatment =replacement therapy

Pernicious Anemia

Deficiency of vitamin B12
-mean ruinous, wicked, evil
-Result from inability to transport vitamin B12 across intestinal mucosa because off a relative lack of gastric sustance (intrinsic factor)
-Causes atrophic gastritis, achlorhydria, neurological changes, megaloblastic, macrocytic anemia

Clinical features:
Weakness, pallor, shortness of breath fatigue on exertion

Tongue: painful and burning, red due to atrophy of papillae
Hunter's or Moeller's glossitis

Treatment=parenteral B12

Iron Deficiency Anemia

-casue by iron deficiency
-Due to dietary intake, impaired absorption, chronic blood loss
Female
-brittlenails and hair and koilonychia (spoon shaped nails)
Tongue: red, painful,smooth
Angular cheilitis
Decreased Hematocit
Treatment =dietary iron

Burning Mouth syndrome

Or burning tongue syndrome
-usually no clinically detectable lesions
(obscure)
>Fungi (candida albicans)= chronic atrophic candidiasis
> Bacteria (staph and strep)
-Xerostomia (Sjogren's syndrome, anxiety, drugs)
-Nutritional deficiences (B vitamin complex, iron, zinc)
-Anemias (iron and pernicious)
-Hormone imbalance (postmenopausal)

-Neuropsychiatric (depressio, anxiety, cancer, phobia, psychogenic)
-Diabetes mellitus
-Mechanical trauma
-Allergy
-idiopathic
Clinical features:
Middle aged women
pain and burning
dysgeusia (altered taste)

Plasma Cell Gingivitis

Allergic or hypersensitivity reaction
-Due to mint or cinnamon flavored gum
clinic features:
> Burning mouth
> onset sudden
> attached gingvia is fiery red ( not ulcerated)
> tongue is atrophic and red
Treatment: stop using

Petechiae and Ecchymoses

Soft tissue hemorrhages
-Petechiae (pinpoint)
-Ecchymosis(bruise) greater than 1 cm
Red and Purple
Intraoral causes
>injury=cheek biting, coughing, fellatio, trauma from prosthetic, iatrogenic
-Blood dyscrasias= leukemia, mononucleosis, thrombocytopenic purpura, hemophilia, Von Willebrand's disease, polycythaemia vera, sickle cell anemia, porphyria

Purpuea (cont.) Pooling of Extravasated Blood in Soft Tissue

Clinical feature
> red to blue to purple
> gingival enlargement (leukemia)
Red Diagnosis
> the inability to otherwise explain appearance of any of these clinical signs should causes clinicians to suspect any of the blood dyscrasias
Gingival enlargment (leukemia)

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set