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Part 1 Mucosal and Soft Tissue Pathology: Color Changes FREQUENCY OF LESION OR COMMENTS OR SPECIAL PAGE OCCURRENCE CONDITION CHARACTERISTICS No. ‘A. WHITE LESIONS: CAN BE SCRAPED OFF ° ‘White coated tongue May be scraped off slightly, with difficulty — a Pseudomembranous candidiasis ilk curd” or “cottage cheese” 163 appearance; may leave red base when rubbed off = Morsicatio Surface may appear to be peeling off an = Thermal bum Example: pizza bur 215 “ ‘Sloughing traumatic lesion Example: cotton roll “burn” 27 os Toothpaste or mouthwash reaction Filmy whiteness; leaves normal appearing 249 mucosa when rubbed off 7 Chemical burn Example: aspirin burn secondary to 216 direct application for toothache * ‘Secondary syphilis Mucous patch; may be only partially 146 scraped off z Diphtheria Gray-white pseudomembrane of 145, ‘oropharynx B. WHITE LESIONS: CANNOT BE SCRAPED OFF - Linea alba ‘Buccal mucosa along ooclusal plane 211 ee Leukoedema Primarily in blacks; milky-white alteration 7 ‘of buccal mucosa bilaterally; disappears when stretched ral Leukoplakia May show benign hyperkeratosis, 280 epithelial dysplasia, or invasive carcinoma ne ‘Tobacco pouch keratosis Usually in mandibular vestibule; 288 associated with use of snuff or chewing tobaooo ae Actinic cheilosis Pale, gray-white, scaly alteration of lower 293 lip; usually in older men with history of chronic sun exposure; precancerous 668 Appendix FREQUENCY OF LESION OR COMMENTS OR SPECIAL PAGE OCCURRENCE CONDITION CHARACTERISTICS No. B. WHITE LESIONS: CANNOT BE SCRAPED OFF Continued * Lichen planus, Wickham’s striae; typically bilateral on 872 buccal mucosa se Morsicatio ‘Most common on anterior buccal au mucosa, labial mucosa, and lateral order of tongue; exhibits ragged surface *, White coated tongue Diffuse involvement of dorsal tongue - = Nicotine stomatitis, Usually associated with pipe smoking: 291 ‘occurs on hard palate Hairy leukoplakia Usually lateral border of tongue; rough 202 surface with vertical fissures; usually associated with HIV infection a Hyperplastic candidiasis Most commonly affects anterior buccal 167 mucosa 7 Lupus erythematosus Most common on buccal mucosa; may 580 ‘mimic lichen planus or leukoplakia; associated skin lesions usually present ® Skin graft History of previous surgery - o ‘Submucous fibrosis ‘More common in South Asia; associated 291 with betel nut chewing . White sponge nevus Hereditary; onset in chitdhood; 542 generalized lesions, especially buccal mucosa 7 Hereditary benign intraepithelial Hereditary; onset in childhood: 543 dyskeratosis generalized lesions, especially buccal mucosa; ocular involvement possible f Pachyonychia congenita Hereditary; onset in childhood: most 545 common on dorsal tongue and areas of trauma; nail, palmar, and plantar changes also present . Dyskeratosis congenita Hereditary; onset in childhood: dystrophic 545 nail changes ; Tertiary syphilis Syphiltic glossitis, 146 s Uremic stomatitis Renal failure 622 C. WHITE AND RED LESIONS ” Erythema migrans ‘Geographic tongue; continually changing 569 patter; rarely involves other oral mucosal sites Diflerentia! Diagnosis Lists TTT 56575 FREQUENCY OF LESION OR COMMENTS OR SPECIAL PAGE OCCURRENCE CONDITION CHARACTERISTICS NO. “ Candidiasis White component may be mbes om 163 wt Lichen planus Atrophic or erosive forms; Wickhem's 572 striae; typically bilateral on buccal mucosa ” Burns Examples: pizza bum, aspirin bum, other 215 chemical bums; white component may be rubbed off 7 Actinic cheilosis, Pale, gray-white and red alteration to 293 lower lip; usually in older men with history of chronic sun exposure > Nicotine stomatitis Usually associated with pipe smoking; 291 ‘occurs on hard palate * Eythroleukoplakia Usually shows epithelial dysplasia or 284 carcinoma, “ Cinnamon reaction Related to cinnamon-flavored gum; 251 typically on buccal mucosa and lateral tongue . Lupus erythematosus Most common on buccal mucosa: may 580 mimic lichen planus or leukoplakia; associated skin lesions usually present - Scarlet fever Secondary to hemolytic streptococcal 144 infection; strawberry/raspberry tongue Verruciform xanthoma Most common on gingiva and hard 267 palate; surface may be papillary D. RED LESIONS = Pharyngitis Examples: strep throat, viral pharyngitis 143 ” ‘Traumatic erythema Caused by local irritation - “ Denture sore mouth Denture-bearing palatal mucosa 166 a Erythematous candidiasis, Example: central papillary atrophy 165 (median rhomboid glossitis) = Erythema migrans Geographic tongue (cases with absence 569 Of white borders); continually changing patter; rarely involves other mucosal sites a Angular chettis Erythema and cracking at labial 166 commissures = ‘Thermal bums Example: caused by hot liquids 215 - Erythropiakia Usually shows epithelial dysplasia or 288 carcinoma Continued