White Lesions

White Lesions

1. Etiology

   • Developmenta
     • leukoedma
     • Genodermatosis
       • genetic condtions
       • White sponge nevus
         • present in childhood
         • bilateral & symmetric
         • thick white velvety plaques
         • canon disease
         • no treatment necessary
         • autosommal dominant
       • heriditary bening intraepithelial dyskeratosis
         • autosommal dominat
         • tri racial isolate in NC
         • Witkop Vonn Sallman
         • Lesions develop in childhood
         • eyes and oral mucosa involved
         • thick corrugulate white plaques on buccan and labial mucosa
         • blindness may result
         • no treatment refer to opthamologist
       • pachyonchia congenita
         • Jackson - lalwer
         • mutations of keratin 6a
         • free margins of nails lifted up because keratinaceos accumulation
         • pinched, tubular, configuration
         • nail loss
         • thick whit plaques that involve lateral margins
         • neonatal teeth associated with keratin 17 mutations 1/3 with oral lesson
       • Dyskeratosi congenita
         • patient suceptial to aplastic aneman ad n squamos cell carcinoma
         • tongue and buccal mucosa bullae , erosion and leukoplakias
         • dysplasia may be seen
         • life span for severely affect 32 yeasts
         • routin check up
   • Infectious
   • immune mediated
   • reactive
     • biggest group as far as prevelance
     • Frictional Hyperkeratsis
       • linea alba
       • chronic biting injury ( morsication, buccarum, labirorum, linguarum
       • benign alvelor ridge keratosi (BARK)
       • Trauma induced white plaque
       • analogous to callus of skin
       • esonse to chronic mechanical irritation
         • maybe dentures
       • reevaluting 2 weeks appropriated
         • if reactive is deemd likely and irritant is elimanted
       • persistant whitele lesions with not likely source of irritation must be biopsided
     • Smokless Tobacco lesions
       • chewing tobacco
       • moist snuff
         • most common used in Sweden and US
       • dry snuff
         • primarily used by women in southern usa
         • highest risk of oral cancer seen
       • spit tobacco
       • usually in males
       • loss of gingiva and periodntaol tissues
       • increased risk of caries
       • altered mucosa feels velvey
       • gray or white translucent plaque with indistint border and ridgin of mucosa
       • cancer may take decaded to develop
       • increased RELATive risk to oral cancer 26
       • 98% of lesion will resolve within 2 weeks of cessation
         • persistant lession must be biopsied
     • nicotine stomatitis
   • neoplastic
   • dysplastic

2. can sometimes be scraped

   • candidiasis

3. NOt scraped off

   • morsicatio
   • white coated tongue
   • luekoedma
   • lichen planus
   • orall hairy leu
   • smokeless tobacco
   • Linea alba
   • nicotinic stomatitis
     • response to heat
     • no maligant potential
     • common in med older than 45
     • palate develips white keratotic surface
     • red papules represent inflamed salivary glands
     • no treatment
     • nictone is not associated to it but it is HEAT
   • Leukoplakia

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