Download PDQ Oral Disease Diagnosis and Treatment by James J. Scuibba, Joseph A. Regezi, Roy S. Rogers PDF

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By James J. Scuibba, Joseph A. Regezi, Roy S. Rogers

PDQ Oral affliction: prognosis and remedy is designed to function a prime resource for the identity of illnesses and stipulations of the mouth and jaws. Dentists and physicians can with ease entry a large spectrum of entities with short, crucial textual content accompanying consultant scientific images and radiographs. Oral mucosal illnesses, salivary gland issues, and odontogenic ailments are integrated in addition to basic health conditions mirrored or manifested within the mouth. A therapeutics part outlines functional remedy techniques to many oral illnesses in the structure of a prescribing formulation to lead the clinician.

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Epithelial thinning, hyperkeratosis • Epithelial dysplasia found in up to 15% of cases Diagnosis • Appearance • History Differential Diagnosis • Lichen sclerosus Treatment • Intralesional corticosteroid placement • Surgical release of scar bands in latter stages • Careful follow-up and vigilance for development of squamous cell carcinoma Prognosis • Irreversible • Fair White Lesions Both photographs courtesy of Dr. John S. Greenspan. 31 32 PDQ ORAL DISEASE White Sponge Nevus Etiology • Hereditary (autosomal-dominant) disorder of keratinization affecting nonkeratinizing oral, esophageal, and anogenital mucosal epithelium • Point mutations in the keratin 4 and/or 13 genes Clinical Presentation • Asymptomatic • Deeply folded, thickened, white mucosa • Buccal mucosa chiefly affected • No functional impairment • Increased prominence during second decade Microscopic Findings • Parakeratosis, acanthosis, intracellular edema • Perinuclear condensation of keratin Diagnosis • Clinical appearance • Family history • Microscopic findings Differential Diagnosis • Idiopathic leukoplakia • Chemical/thermal burn • Chronic low-grade trauma (morsicatio) Treatment • None required • No malignant potential Prognosis • Excellent White Lesions 33 34 PDQ ORAL DISEASE Red/Blue Lesions Ecchymosis Etiology • Soft tissue hemorrhage • Blood dyscrasia with secondary thrombocytopenia, hemophilia • Vascular wall defects • Coagulopathy • Trauma Clinical Presentation • Larger than pinpoint spots (ie, larger than petechiae) • Nonvesicular, macular surface • Lesions do not blanch with pressure • Red to reddish blue to brown color Diagnosis • Characteristic size, color • History • Blood count, coagulation profile Differential Diagnosis • Hemophilia, Kaposi’s sarcoma, hemangioma, thrombocytopenia, von Willebrand’s disease, leukemia, trauma Treatment • Identification of etiology, and corresponding treatment Prognosis • Excellent Red/Blue Lesions 35 36 PDQ ORAL DISEASE Erythroplakia Etiology • Unknown: a red patch that cannot be clinically attributed to another condition • Contributing factors include tobacco use, alcohol consumption Clinical Presentation • Red, often velvety, well-defined patch(es) • Most common on floor of mouth, retromolar trigone area, lateral tongue • Usually asymptomatic • May be smooth to nodular • Chiefly in males Diagnosis • Appearance; history of tobacco/alcohol use • Biopsy results differentiate from inflammatory and atrophic lesions Differential Diagnosis • Erythematous (atrophic) candidiasis • Kaposi’s sarcoma • Ecchymosis • Contact stomatitis • Vascular malformation • Squamous cell carcinoma • Geographic tongue/erythema migrans Treatment • Surgical excision if proven dysplastic/malignant Prognosis • Fair to good depending upon microscopic diagnosis • Almost all cases are premalignant to malignant upon initial discovery.

Patch testing Differential Diagnosis • Lupus erythematosus • Wegener’s granulomatosis • Chronic candidiasis • Lichen planus • Mucous membrane pemphigoid Treatment • Elimination of causative factor Prognosis • Reversal with removal of causative agent Red/Blue Lesions 49 50 PDQ ORAL DISEASE Pyogenic Granuloma Etiology • A reactive hyperplasia of capillaries and fibroblasts • Related to chronic, persistent trauma or irritation (eg, calculus or foreign body) • Misnomer—neither pyogenic nor granulomatous Clinical Presentation • Occurs at any age, but usually in children, young adults, and women • Red, lobular to smoothly contoured appearance • When ulcerated, a yellow fibrinous exudate covers the lesion.

Individual cells with clear cytoplasm and compact nuclei • Normal basal cell layer Differential Diagnosis • Cheek chewing • Hereditary benign intraepithelial dyskeratosis • White sponge nevus • Lichen planus • Candidiasis Treatment • None necessary; no relation to dysplasia/carcinoma • Reassurance Prognosis • Excellent White Lesions 17 18 PDQ ORAL DISEASE Leukoplakia Etiology • Essentially unknown, although many cases related to use of tobacco or areca nut in its various formulations • Other possible factors include nutritional deficiency (iron, vitamin A) and infection (Candida albicans, human papillomavirus).

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