Sandbox leucocytosis: Difference between revisions

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{| class="wikitable"
|+
!Oral lesion
!Differentiating feature
!Location
!Associated condition
|-
! colspan="4" |White lesions
|-
|Benign migratory glossitis<ref name="pmid12517366">{{cite journal |vauthors=Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M |title=Benign migratory glossitis or geographic tongue: an enigmatic oral lesion |journal=Am. J. Med. |volume=113 |issue=9 |pages=751–5 |date=December 2002 |pmid=12517366 |doi= |url=}}</ref><ref name="pmid27579734">{{cite journal |vauthors=Picciani BL, Domingos TA, Teixeira-Souza T, Santos Vde C, Gonzaga HF, Cardoso-Oliveira J, Gripp AC, Dias EP, Carneiro S |title=Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review |journal=An Bras Dermatol |volume=91 |issue=4 |pages=410–21 |date=2016 |pmid=27579734 |pmc=4999097 |doi=10.1590/abd1806-4841.20164288 |url=}}</ref><ref name="pmid25584342">{{cite journal |vauthors=Tarakji B, Umair A, Babaker Z, Sn A, Gazal G, Sarraj F |title=Relation between psoriasis and geographic tongue |journal=J Clin Diagn Res |volume=8 |issue=11 |pages=ZE06–7 |date=November 2014 |pmid=25584342 |pmc=4290356 |doi=10.7860/JCDR/2014/9101.5171 |url=}}</ref>
|
* Red patches with white distinct border
* Map like appearance
|Dorsal/Lateral surface of the [[tongue]]
|
* [[Psoriasis]]
* [[Diabetes mellitus|Diabetes]]
* [[Reiter's syndrome]]
* Medications such as [[oral contraceptive pills]] and [[lithium carbonate]]
* [[Pregnancy]]
|-
|Hairy tongue<ref name="pmid20706544">{{cite journal |vauthors=Kobayashi K, Takei Y, Sawada M, Ishizaki S, Ito H, Tanaka M |title=Dermoscopic features of a black hairy tongue in 2 Japanese patients |journal=Dermatol Res Pract |volume=2010 |issue= |pages= |date=2010 |pmid=20706544 |pmc=2913535 |doi=10.1155/2010/145878 |url=}}</ref><ref name="pmid27298505">{{cite journal |vauthors=Jhaj R, Gour PR, Asati DP |title=Black hairy tongue with a fixed dose combination of olanzapine and fluoxetine |journal=Indian J Pharmacol |volume=48 |issue=3 |pages=318–20 |date=2016 |pmid=27298505 |pmc=4900008 |doi=10.4103/0253-7613.182894 |url=}}</ref><ref name="pmid25152586">{{cite journal |vauthors=Gurvits GE, Tan A |title=Black hairy tongue syndrome |journal=World J. Gastroenterol. |volume=20 |issue=31 |pages=10845–50 |date=August 2014 |pmid=25152586 |pmc=4138463 |doi=10.3748/wjg.v20.i31.10845 |url=}}</ref><ref name="pmid27011938">{{cite journal |vauthors=Erriu M, Pili FM, Denotti G, Garau V |title=Black hairy tongue in a patient with amyotrophic lateral sclerosis |journal=J Int Soc Prev Community Dent |volume=6 |issue=1 |pages=80–3 |date=2016 |pmid=27011938 |pmc=4784070 |doi=10.4103/2231-0762.175408 |url=}}</ref>
|
* Elongated filliform lingual papilae
* Carpet-like appearance
|Dorsum of the tongue
|
* [[Xerostomia]]
|-
|[[Leukoedema]]<ref name="pmid19444343">{{cite journal |vauthors=Jahanbani J, Sandvik L, Lyberg T, Ahlfors E |title=Evaluation of oral mucosal lesions in 598 referred Iranian patients |journal=Open Dent J |volume=3 |issue= |pages=42–7 |date=March 2009 |pmid=19444343 |doi=10.2174/1874210600903010042 |url=}}</ref><ref name="pmid27042583">{{cite journal |vauthors=Abidullah M, Raghunath V, Karpe T, Akifuddin S, Imran S, Dhurjati VN, Aleem MA, Khatoon F |title=Clinicopathologic Correlation of White, Non scrapable Oral Mucosal Surface Lesions: A Study of 100 Cases |journal=J Clin Diagn Res |volume=10 |issue=2 |pages=ZC38–41 |date=February 2016 |pmid=27042583 |pmc=4800649 |doi=10.7860/JCDR/2016/16950.7226 |url=}}</ref>
|
* White or whitish-gray edematous lesion
* [[Diffuse]] or patchy
|[[Buccal]] and [[labial]] [[oral mucosa]]
|
|-
|[[White sponge nevus]]<ref name="pmid23230487">{{cite journal |vauthors=Aghbali A, Pouralibaba F, Eslami H, Pakdel F, Jamali Z |title=White sponge nevus: a case report |journal=J Dent Res Dent Clin Dent Prospects |volume=3 |issue=2 |pages=70–2 |date=2009 |pmid=23230487 |pmc=3517290 |doi=10.5681/joddd.2009.017 |url=}}</ref><ref name="pmid2381643">{{cite journal |vauthors=Nichols GE, Cooper PH, Underwood PB, Greer KE |title=White sponge nevus |journal=Obstet Gynecol |volume=76 |issue=3 Pt 2 |pages=545–8 |date=September 1990 |pmid=2381643 |doi= |url=}}</ref>
|
* White patches of [[tissue]] ([[nevi]])
* Singular or multiple
* Thickened, velvety, [[sponge]]-like appearance
|The moist lining of the [[oral mucosa]] [[buccal mucosa]]
|
|-
|[[Hairy leukoplakia]]<ref name="pmid21398239">{{cite journal |vauthors=Kreuter A, Wieland U |title=Oral hairy leukoplakia: a clinical indicator of immunosuppression |journal=CMAJ |volume=183 |issue=8 |pages=932 |date=May 2011 |pmid=21398239 |pmc=3091903 |doi=10.1503/cmaj.100841 |url=}}</ref><ref name="pmid27109280">{{cite journal |vauthors=Greenspan JS, Greenspan D, Webster-Cyriaque J |title=Hairy leukoplakia; lessons learned: 30-plus years |journal=Oral Dis |volume=22 Suppl 1 |issue= |pages=120–7 |date=April 2016 |pmid=27109280 |doi=10.1111/odi.12393 |url=}}</ref>
|
* White patches
** Corrugated in appearance
** Hairy, hair-like growths
** Permanent
|
* Lateral portions of the [[tongue]]
* Floor of the mouth
* [[Palate]]
* [[Buccal mucosa]]
|
* [[Epstein Barr virus|EBV]] virus infection
* [[Immunosupression]]
|-
|[[Oral lichen planus]]<ref name="pmid24672362">{{cite journal |vauthors=Gorouhi F, Davari P, Fazel N |title=Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis |journal=ScientificWorldJournal |volume=2014 |issue= |pages=742826 |date=2014 |pmid=24672362 |pmc=3929580 |doi=10.1155/2014/742826 |url=}}</ref><ref name="pmid26120146">{{cite journal |vauthors=Gupta S, Jawanda MK |title=Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management |journal=Indian J Dermatol |volume=60 |issue=3 |pages=222–9 |date=2015 |pmid=26120146 |pmc=4458931 |doi=10.4103/0019-5154.156315 |url=}}</ref>
|
* [[Reticular]] or papular lace like white lesions
* Multiple, Painful
|
* Posterior [[buccal mucosa]]
* [[Gingival]] margin
|
|-
|Nicotinic stomatitis<ref name="pmid19626226">{{cite journal |vauthors=dos Santos RB, Katz J |title=Nicotinic stomatitis: positive correlation with heat in maté tea drinks and smoking |journal=Quintessence Int |volume=40 |issue=7 |pages=537–40 |date=2009 |pmid=19626226 |doi= |url=}}</ref><ref name="pmid27034758">{{cite journal |vauthors=Naveen-Kumar B, Tatapudi R, Sudhakara-Reddy R, Alapati S, Pavani K, Sai-Praveen KN |title=Various forms of tobacco usage and its associated oral mucosal lesions |journal=J Clin Exp Dent |volume=8 |issue=2 |pages=e172–7 |date=April 2016 |pmid=27034758 |pmc=4808313 |doi=10.4317/jced.52654 |url=}}</ref>
|
* Reddened area and slowly progresses to a white, thickened, and [[fissured]]
* White cobblestone appearance
* Red dot in the center
* Cannot be wiped off
* '''Painful'''
|
* [[Palatal]] [[mucosa]]
* Posterior [[hard palate]]
|Smokers
|-
|Oral frictional hyperkeratosis<ref name="pmid22545331">{{cite journal |vauthors=Cam K, Santoro A, Lee JB |title=Oral frictional hyperkeratosis (morsicatio buccarum): an entity to be considered in the differential diagnosis of white oral mucosal lesions |journal=Skinmed |volume=10 |issue=2 |pages=114–5 |date=2012 |pmid=22545331 |doi= |url=}}</ref><ref name="pmid21216078">{{cite journal |vauthors=Mignogna MD, Fortuna G, Leuci S, Adamo D, Siano M, Makary C, Cafiero C |title=Frictional keratoses on the facial attached gingiva are rare clinical findings and do not belong to the category of leukoplakia |journal=J. Oral Maxillofac. Surg. |volume=69 |issue=5 |pages=1367–74 |date=May 2011 |pmid=21216078 |doi=10.1016/j.joms.2010.05.087 |url=}}</ref>
|
* White shaggy plaques
* Could be easily peeled without any pain leaving normal [[mucosa]]
|
* Bilateral [[buccal mucosa]]
* Limited to the line of dental occlusion
|
|-
|Fordyce granules<ref name="pmid22363169">{{cite journal |vauthors=Lee JH, Lee JH, Kwon NH, Yu DS, Kim GM, Park CJ, Lee JD, Kim SY |title=Clinicopathologic Manifestations of Patients with Fordyce's Spots |journal=Ann Dermatol |volume=24 |issue=1 |pages=103–6 |date=February 2012 |pmid=22363169 |pmc=3283840 |doi=10.5021/ad.2012.24.1.103 |url=}}</ref><ref name="pmid16711559">{{cite journal |vauthors=Olivier JH |title=Fordyce granules on the prolabial and oral mucous membranes of a selected population |journal=SADJ |volume=61 |issue=2 |pages=072–4 |date=March 2006 |pmid=16711559 |doi= |url=}}</ref><ref name="pmid15879014">{{cite journal |vauthors=De Felice C, Parrini S, Chitano G, Gentile M, Dipaola L, Latini G |title=Fordyce granules and hereditary non-polyposis colorectal cancer syndrome |journal=Gut |volume=54 |issue=9 |pages=1279–82 |date=September 2005 |pmid=15879014 |doi=10.1136/gut.2005.064881 |url=}}</ref><ref name="pmid25213213">{{cite journal |vauthors=Ponti G, Meschieri A, Pollio A, Ruini C, Manfredini M, Longo C, Mandel VD, Ciardo S, Tomasi A, Giannetti L, Pellacani G |title=Fordyce granules and hyperplastic mucosal sebaceous glands as distinctive stigmata in Muir-Torre syndrome patients: characterization with reflectance confocal microscopy |journal=J. Oral Pathol. Med. |volume=44 |issue=7 |pages=552–7 |date=August 2015 |pmid=25213213 |doi=10.1111/jop.12256 |url=}}</ref>
|
* White to yellow discrete [[papules]],
* 1 to 2 mm
|
* Symmetrically distributed
** [[Buccal mucosa]]
** [[Vermillion border]] of the [[lips]]
|
* Hereditary non-polyposis colorectal cancer
* Muir-torre syndrome
|}
{| class="wikitable"
|+
! colspan="4" |Infectious oral Lesions
|-
!Disease
!Differentiating feautures
!Location
!Image
|-
|[[Herpes simplex virus]] infections<ref name="pmid23839615">{{cite journal |vauthors=Mohan RP, Verma S, Singh U, Agarwal N |title=Acute primary herpetic gingivostomatitis |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=July 2013 |pmid=23839615 |pmc=3736476 |doi=10.1136/bcr-2013-200074 |url=}}</ref><ref name="pmid19169443">{{cite journal |vauthors=Tovaru S, Parlatescu I, Tovaru M, Cionca L |title=Primary herpetic gingivostomatitis in children and adults |journal=Quintessence Int |volume=40 |issue=2 |pages=119–24 |date=February 2009 |pmid=19169443 |doi= |url=}}</ref><ref name="pmid9334868">{{cite journal |vauthors=Amir J, Nussinovitch M, Kleper R, Cohen HA, Varsano I |title=Primary herpes simplex virus type 1 gingivostomatitis in pediatric personnel |journal=Infection |volume=25 |issue=5 |pages=310–2 |date=1997 |pmid=9334868 |doi= |url=}}</ref>
|[[Herpetic gingivostomatitis]]
* Painful [[ulcers]] covered by a yellowish pseudomembrane
* [[Ulcers]] that may coalesce to form bigger lesions
* Self limiting after 7 days
|[[Keratinized]] and non-keratinized [[mucosa]]. Commonly seen on:
* [[Gums]]
* [[Palate]]
* [[Tongue]]
* [[Lips]]
|
|-
|[[Herpes zoster Infection|Herpes zoster]]<ref name="pmid23771975">{{cite journal |vauthors=Mohan RP, Verma S, Singh U, Agarwal N |title=Herpes zoster |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=June 2013 |pmid=23771975 |pmc=3702907 |doi=10.1136/bcr-2013-010246 |url=}}</ref><ref name="pmid23559842">{{cite journal |vauthors=Patil S, Srinivas K, Reddy BS, Gupta M |title=Prodromal herpes zoster mimicking odontalgia--a diagnostic challenge |journal=Ethiop J Health Sci |volume=23 |issue=1 |pages=73–7 |date=March 2013 |pmid=23559842 |pmc=3613819 |doi= |url=}}</ref><ref name="pmid11314207">{{cite journal |vauthors=Kolokotronis A, Louloudiadis K, Fotiou G, Matiais A |title=Oral manifestations of infections of infections due to varicella zoster virus in otherwise healthy children |journal=J Clin Pediatr Dent |volume=25 |issue=2 |pages=107–12 |date=2001 |pmid=11314207 |doi= |url=}}</ref>
|
* [[Prodromal]] unilateral [[pain]]
* Clustered small [[ulcers]] with characteristic unilateral pattern
* Self limiting, heal within 10-14 days
|
* [[Hard palate]].
* [[Buccal mucosa]]
* [[Tongue]]
* [[Gingival|Gingiva]]
|
|-
|[[Hand foot mouth disease]]<ref name="pmid21911958">{{cite journal |vauthors=Muppa R, Bhupatiraju P, Duddu M, Dandempally A |title=Hand, foot and mouth disease |journal=J Indian Soc Pedod Prev Dent |volume=29 |issue=2 |pages=165–7 |date=2011 |pmid=21911958 |doi=10.4103/0970-4388.84692 |url=}}</ref><ref name="pmid26155357">{{cite journal |vauthors=Kashyap RR, Kashyap RS |title=Hand, foot and mouth disease - a short case report |journal=J Clin Exp Dent |volume=7 |issue=2 |pages=e336–8 |date=April 2015 |pmid=26155357 |pmc=4483348 |doi=10.4317/jced.52031 |url=}}</ref><ref name="pmid26302092">{{cite journal |vauthors=Liu B, Luo L, Yan S, Wen T, Bai W, Li H, Zhang G, Lu X, Liu Y, He L |title=Clinical Features for Mild Hand, Foot and Mouth Disease in China |journal=PLoS ONE |volume=10 |issue=8 |pages=e0135503 |date=2015 |pmid=26302092 |pmc=4547800 |doi=10.1371/journal.pone.0135503 |url=}}</ref>
|
* Oval-shaped, pale papules with a rim of [[erythema]]
* Small aphthae
|Lesions spare the [[lips]] and [[gingiva]], in contrast to [[HSV]]
|
|-
|[[Infectious mononucliosis]]<ref name="pmid21233512">{{cite journal |vauthors=Odumade OA, Hogquist KA, Balfour HH |title=Progress and problems in understanding and managing primary Epstein-Barr virus infections |journal=Clin. Microbiol. Rev. |volume=24 |issue=1 |pages=193–209 |date=January 2011 |pmid=21233512 |pmc=3021204 |doi=10.1128/CMR.00044-10 |url=}}</ref><ref name="pmid27588199">{{cite journal |vauthors=Grimm JM, Schmeling DO, Dunmire SK, Knight JA, Mullan BD, Ed JA, Brundage RC, Hogquist KA, Balfour HH |title=Prospective studies of infectious mononucleosis in university students |journal=Clin Transl Immunology |volume=5 |issue=8 |pages=e94 |date=August 2016 |pmid=27588199 |doi=10.1038/cti.2016.48 |url=}}</ref>
|[[Pharyngitis]]
* Tonsillar exudates
* Appear white, gray-green, or even [[necrotic]]
* Palatal [[petechiae]] with streaky [[hemorrhages]] and blotchy red [[macules]]
|
* [[Pharynx]]
* [[Tonsils]]
|
|-
|Erosive [[lichen planus]]<ref name="pmid22615505">{{cite journal |vauthors=Omal P, Jacob V, Prathap A, Thomas NG |title=Prevalence of oral, skin, and oral and skin lesions of lichen planus in patients visiting a dental school in southern India |journal=Indian J Dermatol |volume=57 |issue=2 |pages=107–9 |date=March 2012 |pmid=22615505 |pmc=3352630 |doi=10.4103/0019-5154.94276 |url=}}</ref><ref name="pmid26681847">{{cite journal |vauthors=Belal MH |title=Management of symptomatic erosive-ulcerative lesions of oral lichen planus in an adult Egyptian population using Selenium-ACE combined with topical corticosteroids plus antifungal agent |journal=Contemp Clin Dent |volume=6 |issue=4 |pages=454–60 |date=2015 |pmid=26681847 |pmc=4678540 |doi=10.4103/0976-237X.169837 |url=}}</ref><ref name="pmid26538905">{{cite journal |vauthors=Chitturi RT, Sindhuja P, Parameswar RA, Nirmal RM, Reddy BV, Dineshshankar J, Yoithapprabhunath TR |title=A clinical study on oral lichen planus with special emphasis on hyperpigmentation |journal=J Pharm Bioallied Sci |volume=7 |issue=Suppl 2 |pages=S495–8 |date=August 2015 |pmid=26538905 |pmc=4606647 |doi=10.4103/0975-7406.163513 |url=}}</ref>
|
* [[Ulcerative stomatitis]]
**
|
* [[Buccal mucosa]]
* Sides of the [[tongue]]
* [[Gingiva]]
* [[Lips]]
|
|-
|Pseudomembranous [[candidiasis]]<ref name="pmid21547018">{{cite journal |vauthors=Williams D, Lewis M |title=Pathogenesis and treatment of oral candidosis |journal=J Oral Microbiol |volume=3 |issue= |pages= |date=January 2011 |pmid=21547018 |pmc=3087208 |doi=10.3402/jom.v3i0.5771 |url=}}</ref><ref name="pmid26538978">{{cite journal |vauthors=Warrier SA, Sathasivasubramanian S |title=Human immunodeficiency virus induced oral candidiasis |journal=J Pharm Bioallied Sci |volume=7 |issue=Suppl 2 |pages=S812–4 |date=August 2015 |pmid=26538978 |pmc=4606720 |doi=10.4103/0975-7406.163577 |url=}}</ref><ref name="pmid22111010">{{cite journal |vauthors=Byadarahally Raju S, Rajappa S |title=Isolation and identification of Candida from the oral cavity |journal=ISRN Dent |volume=2011 |issue= |pages=487921 |date=2011 |pmid=22111010 |pmc=3205665 |doi=10.5402/2011/487921 |url=}}</ref>
|
* Known as [[thrush]].
* Usually [[asymptomatic]].
* Confluent white wipeable plaques resembling curdled milk
* Superficially the plaques can be wiped off and the underlying [[mucosa]] often exhibits an [[erythematous]] appearance.
|
* [[Oral mucosa]],
* [[Tongue]]
* [[Buccal mucosa]]
* [[Hard palate]]
|
|-
|[[Histoplasmosis]]<ref name="pmid28255468">{{cite journal |vauthors=Chatterjee D, Chatterjee A, Agarwal M, Mathur M, Mathur S, Mallikarjun R, Banerjee S |title=Disseminated Histoplasmosis with Oral Manifestation in an Immunocompetent Patient |journal=Case Rep Dent |volume=2017 |issue= |pages=1323514 |date=2017 |pmid=28255468 |pmc=5306962 |doi=10.1155/2017/1323514 |url=}}</ref><ref name="pmid23798850">{{cite journal |vauthors=Vidyanath S, Shameena P, Sudha S, Nair RG |title=Disseminated histoplasmosis with oral and cutaneous manifestations |journal=J Oral Maxillofac Pathol |volume=17 |issue=1 |pages=139–42 |date=January 2013 |pmid=23798850 |pmc=3687172 |doi=10.4103/0973-029X.110722 |url=}}</ref><ref name="pmid20379415">{{cite journal |vauthors=Patil K, Mahima VG, Prathibha Rani RM |title=Oral histoplasmosis |journal=J Indian Soc Periodontol |volume=13 |issue=3 |pages=157–9 |date=September 2009 |pmid=20379415 |pmc=2848788 |doi=10.4103/0972-124X.60230 |url=}}</ref><ref name="pmid23853464">{{cite journal |vauthors=Brazão-Silva MT, Mancusi GW, Bazzoun FV, Ishisaki GY, Marcucci M |title=A gingival manifestation of histoplasmosis leading diagnosis |journal=Contemp Clin Dent |volume=4 |issue=1 |pages=97–101 |date=January 2013 |pmid=23853464 |pmc=3703707 |doi=10.4103/0976-237X.111621 |url=}}</ref><ref name="pmid29267463">{{cite journal |vauthors=Souza BC, Munerato MC |title=Oral manifestation of histoplasmosis on the palate |journal=An Bras Dermatol |volume=92 |issue=5 Suppl 1 |pages=107–109 |date=2017 |pmid=29267463 |pmc=5726694 |doi=10.1590/abd1806-4841.20175751 |url=}}</ref>
|
* Disease affect the lungs and cause [[acute]] or [[chronic]] [[respiratory]] problems in the [[immunocompromised]] population.
* Ulcerating erosive or [[nodular]] lesions in the oral [[mucous membrane]].
* The [[oral lesions]] may also appear [[granulomatous]] and may be painful
* The [[ulcers]] may often resemble [[carcinoma]] or [[tuberculosis]] because of the raised and rolled borders, usually covered by a yellow or greyish membrane.
|
* [[Oral mucosa]]
* [[Tongue]]
* [[Palate]]
* [[Lips]]
|Ohio and Mississippi river valleys
|-
|[[Blastomycosis]]<ref name="pmid20072023">{{cite journal |vauthors=Kruse AL, Zwahlen RA, Bredell MG, Gengler C, Dannemann C, Grätz KW |title=Primary blastomycosis of oral cavity |journal=J Craniofac Surg |volume=21 |issue=1 |pages=121–3 |date=January 2010 |pmid=20072023 |doi=10.1097/SCS.0b013e3181c4680c |url=}}</ref><ref name="pmid24899035">{{cite journal |vauthors=Thomas J, Munson E, Christianson JC |title=Unexpected Blastomyces dermatitidis etiology of fungal sinusitis and erosive palatal infection in a diabetic patient |journal=J. Clin. Microbiol. |volume=52 |issue=8 |pages=3130–3 |date=August 2014 |pmid=24899035 |pmc=4136175 |doi=10.1128/JCM.01392-14 |url=}}</ref><ref name="pmid24963249">{{cite journal |vauthors=Webber LP, Martins MD, de Oliveira MG, Munhoz EA, Carrard VC |title=Disseminated paracoccidioidomycosis diagnosis based on oral lesions |journal=Contemp Clin Dent |volume=5 |issue=2 |pages=213–6 |date=April 2014 |pmid=24963249 |pmc=4067786 |doi=10.4103/0976-237X.132340 |url=}}</ref>
|
* Ulcerative [[mucosal]] lesions
* Sessile projections, [[granulomatous]] or verrucous lesions.
* Small [[ulcers]] are characteristic oral manifestation and may present as a primary lesion or secondary to [[Disseminated disease|disseminated]] disease.
* [[Oral lesions]] may resemble [[actinomycosis]] without the [[suppurative]] element
|
|Mississippi, Missouri and Ohio River valleys and the Great lakes region.
|-
|[[Coccidiodomycosis]]<ref name="pmid28386282">{{cite journal |vauthors=Mendez LA, Flores SA, Martinez R, de Almeida OP |title=Ulcerated Lesion of the Tongue as Manifestation of Systemic Coccidioidomycosis |journal=Case Rep Med |volume=2017 |issue= |pages=1489501 |date=2017 |pmid=28386282 |pmc=5366790 |doi=10.1155/2017/1489501 |url=}}</ref><ref name="pmid15628927">{{cite journal |vauthors=Rodriguez RA, Konia T |title=Coccidioidomycosis of the tongue |journal=Arch. Pathol. Lab. Med. |volume=129 |issue=1 |pages=e4–6 |date=January 2005 |pmid=15628927 |doi=10.1043/1543-2165(2005)129<e4:COTT>2.0.CO;2 |url=}}</ref><ref name="pmid28228898">{{cite journal |vauthors=McConnell MF, Shi A, Lasco TM, Yoon L |title=Disseminated coccidioidomycosis with multifocal musculoskeletal disease involvement |journal=Radiol Case Rep |volume=12 |issue=1 |pages=141–145 |date=March 2017 |pmid=28228898 |pmc=5310389 |doi=10.1016/j.radcr.2016.11.017 |url=}}</ref><ref name="pmid16707052">{{cite journal |vauthors=Valdivia L, Nix D, Wright M, Lindberg E, Fagan T, Lieberman D, Stoffer T, Ampel NM, Galgiani JN |title=Coccidioidomycosis as a common cause of community-acquired pneumonia |journal=Emerging Infect. Dis. |volume=12 |issue=6 |pages=958–62 |date=June 2006 |pmid=16707052 |pmc=3373055 |doi= |url=}}</ref>
|
* [[Asymptomatic]]
* [[Pulmonary]] or extrapulmonary disease
* [[Oral lesions]] are uncommon
* Described as [[Ulcerated lesion|ulcerated]] [[granulomatous]] [[nodules]]
* [[Ulcers]] appear nonspecific and usually heal by hyalinization and [[scar]]
|No specific location
|
|}
__NOTOC__
__NOTOC__
<div style="width: 70%;">
<small><small></small></small>
{| class="wikitable sortable"
|-
! colspan="5" |Pigmented lesions
|-
! colspan="2" |Oral lesion
!Differentiating feature
!Location
!Associated Condition
|-
| colspan="2" |'''Physiologic'''<ref name="pmid24661309">{{cite journal |vauthors=Feller L, Masilana A, Khammissa RA, Altini M, Jadwat Y, Lemmer J |title=Melanin: the biophysiology of oral melanocytes and physiological oral pigmentation |journal=Head Face Med |volume=10 |issue= |pages=8 |date=March 2014 |pmid=24661309 |pmc=3994327 |doi=10.1186/1746-160X-10-8 |url=}}</ref><ref name="pmid23277862">{{cite journal |vauthors=Talebi M, Farmanbar N, Abolfazli S, Sarraf Shirazi A |title=Management of physiological hyperpigmentation of oral mucosa by cryosurgical treatment: a case report |journal=J Dent Res Dent Clin Dent Prospects |volume=6 |issue=4 |pages=148–51 |date=2012 |pmid=23277862 |doi=10.5681/joddd.2012.030 |url=}}</ref>
|
* Multifocal, [[Symmetric function|symmetric]], persistent and race [[inherited]]
* Dark-brown band
|
* [[Gingival]] margins
|
|-
| rowspan="2" |'''Intravascular'''
|'''Hemangioma'''<ref name="pmid24263242">{{cite journal |vauthors=da Silva WB, Ribeiro AL, de Menezes SA, de Jesus Viana Pinheiro J, de Melo Alves-Junior S |title=Oral capillary hemangioma: a clinical protocol of diagnosis and treatment in adults |journal=Oral Maxillofac Surg |volume=18 |issue=4 |pages=431–7 |date=December 2014 |pmid=24263242 |doi=10.1007/s10006-013-0436-z |url=}}</ref><ref name="pmid20181211">{{cite journal |vauthors=Dilsiz A, Aydin T, Gursan N |title=Capillary hemangioma as a rare benign tumor of the oral cavity: a case report |journal=Cases J |volume=2 |issue= |pages=8622 |date=September 2009 |pmid=20181211 |pmc=2827094 |doi=10.1186/1757-1626-0002-0000008622 |url=}}</ref><ref name="pmid23998020">{{cite journal |vauthors=Agarwal S |title=Treatment of oral hemangioma with 3% sodium tetradecyl sulfate: study of 20 cases |journal=Indian J Otolaryngol Head Neck Surg |volume=64 |issue=3 |pages=205–7 |date=September 2012 |pmid=23998020 |pmc=3431531 |doi=10.1007/s12070-011-0249-z |url=}}</ref>
|
* Red or bluish-red, slightly raised [[lesions]]
* Rapidly during infancy and regress slowly during childhood
|
* [[Lip]]
* Dorsum of the [[tongue]]
* [[Gingiva]]
* [[Buccal mucosa]]
|
* [[Rendu-Osler-Weber syndrome]]
* [[Sturge-Weber syndrome]]
* [[Kasabach-Merritt syndrome]]
* [[Maffucci syndrome]]
* [[Klippel-Trenaunay-Weber syndrome]]
* PHACE(S)
|-
|'''Kaposi sarcoma'''<ref name="pmid26283853">{{cite journal |vauthors=Arul AS, Kumar AR, Verma S, Arul AS |title=Oral Kaposi's sarcoma: Sole presentation in HIV seropositive patient |journal=J Nat Sci Biol Med |volume=6 |issue=2 |pages=459–61 |date=2015 |pmid=26283853 |doi=10.4103/0976-9668.160041 |url=}}</ref><ref name="pmid22021973">{{cite journal |vauthors=Mehta S, Garg A, Gupta LK, Mittal A, Khare AK, Kuldeep CM |title=Kaposi's sarcoma as a presenting manifestation of HIV |journal=Indian J Sex Transm Dis AIDS |volume=32 |issue=2 |pages=108–10 |date=July 2011 |pmid=22021973 |pmc=3195171 |doi=10.4103/0253-7184.85415 |url=}}</ref>
|
* Purplish, reddish blue or dark brown [[macules]]
* [[Plaques]] and [[nodules]] that may [[Ulcerated lesion|ulcerate]]
*
|
* [[Skin]]
|
* [[Immunosuppression]]
* [[HIV AIDS]]
|-
| rowspan="3" |'''Extra-vascular'''
|'''Hematoma'''
|
|
|
|-
|'''Ecchymosis'''
|
* Nonpalpable [[purpuric]] [[spots]]
*
|
* [[Palate]]
* [[Tongue]]
* [[Lips]]
|
* [[Aging]]
* Chronic usage of
** [[Nonsteroidal anti-inflammatory drugs]] ([[NSAIDs]])
** [[Corticosteroids]]
** [[Anticoagulants]]
* Deficiency of [[zinc]]
* [[Liver diseases]]
|-
|Petechiae
|
|
|
|-
| rowspan="3" |Melanocytic
|'''Oral melanocytic macule'''<ref name="pmid17767102">{{cite journal |vauthors=Carlos-Bregni R, Contreras E, Netto AC, Mosqueda-Taylor A, Vargas PA, Jorge J, León JE, de Almeida OP |title=Oral melanoacanthoma and oral melanotic macule: a report of 8 cases, review of the literature, and immunohistochemical analysis |journal=Med Oral Patol Oral Cir Bucal |volume=12 |issue=5 |pages=E374–9 |date=September 2007 |pmid=17767102 |doi= |url=}}</ref><ref name="pmid15491090">{{cite journal |vauthors=Pais S, Hegde SK, Bhat SS |title=Oral melanotic macule--a case report |journal=J Indian Soc Pedod Prev Dent |volume=22 |issue=2 |pages=73–5 |date=June 2004 |pmid=15491090 |doi= |url=}}</ref>
|
* Focal [[Pigmented Lesions|pigmented]] brown [[lesions]] similar to ephelides
* Flat and mostly smaller than 1 cm
* Characterised by a focal increase in [[melanin]] production
|
* [[Vermillion border]] of the [[lips]]
|
|-
|'''Oral melanoacanthoma'''<ref name="pmid27398186">{{cite journal |vauthors=Cantudo-Sanagustín E, Gutiérrez-Corrales A, Vigo-Martínez M, Serrera-Figallo MÁ, Torres-Lagares D, Gutiérrez-Pérez JL |title=Pathogenesis and clinicohistopathological caractheristics of melanoacanthoma: A systematic review |journal=J Clin Exp Dent |volume=8 |issue=3 |pages=e327–36 |date=July 2016 |pmid=27398186 |pmc=4930645 |doi=10.4317/jced.52860 |url=}}</ref><ref name="pmid29387765">{{cite journal |vauthors=Peters SM, Mandel L, Perrino MA |title=Oral melanoacanthoma of the palate: An unusual presentation of an uncommon entity |journal=JAAD Case Rep |volume=4 |issue=2 |pages=138–139 |date=March 2018 |pmid=29387765 |doi=10.1016/j.jdcr.2017.11.023 |url=}}</ref><ref name="pmid23248484">{{cite journal |vauthors=Gupta AA, Nainani P, Upadhyay B, Kavle P |title=Oral melanoacanthoma: A rare case of diffuse oral pigmentation |journal=J Oral Maxillofac Pathol |volume=16 |issue=3 |pages=441–3 |date=September 2012 |pmid=23248484 |doi=10.4103/0973-029X.102514 |url=}}</ref>
|
* Rapidly enlarging, [[asymptomatic]], [[Pigmented Lesions|pigmented]] [[Macules|macule]].
|
* [[Buccal mucosa]]
|
* Local [[trauma]] or chronic [[irritation]]
|-
|'''Ephelis'''
|
* Flat red or light brown [[spots]]
* 3–10 mm in diameter
* Poorly defined and may merge into large patches
|
* Outer [[lips]]
|
* Exposure to [[ultraviolet radiation]]
|-
! colspan="5" |Diffuse
|-
| colspan="2" |[[Addison's disease]]<ref name="pmid23893277">{{cite journal |vauthors=Puttanna A, Cunningham AR, Dainty P |title=Addison's disease and its associations |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=July 2013 |pmid=23893277 |pmc=3736622 |doi=10.1136/bcr-2013-010473 |url=}}</ref><ref name="pmid23633816">{{cite journal |vauthors=Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S |title=Addison's disease |journal=Contemp Clin Dent |volume=3 |issue=4 |pages=484–6 |date=October 2012 |pmid=23633816 |pmc=3636818 |doi=10.4103/0976-237X.107450 |url=}}</ref>
|
* [[Mucosal]] [[hyperpigmentation]]
*
|
Brown patches of
* [[Gingiva|Gingival]]
* [[Vermillion border]] of the [[lips]]
* [[Buccal mucosa]], [[palate]] and [[tongue]]
|
|-
| colspan="2" |[[Peutz-Jeghers syndrome]]<ref name="pmid27195155">{{cite journal |vauthors=Mozaffari HR, Rezaei F, Sharifi R, Mirbahari SG |title=Seven-Year Follow-Up of Peutz-Jeghers Syndrome |journal=Case Rep Dent |volume=2016 |issue= |pages=6052181 |date=2016 |pmid=27195155 |pmc=4852371 |doi=10.1155/2016/6052181 |url=}}</ref><ref name="pmid10102516">{{cite journal |vauthors=Choi HS, Park YJ, Park JG |title=Peutz-Jeghers syndrome: a new understanding |journal=J. Korean Med. Sci. |volume=14 |issue=1 |pages=2–7 |date=February 1999 |pmid=10102516 |pmc=3054160 |doi=10.3346/jkms.1999.14.1.2 |url=}}</ref>
|
* [[Inherited]], [[autosomal dominant]]
* Flat, painless brown [[Pigmented lesions|pigmented]] patches
* Microscopically mild acanthosis with elongation of the [[rete pegs]] with increased [[pigmentation]] in the [[melanocytes]] and adjacent [[keratinocytes]]
|[[Perioral]]
* Freckling of the skin around lips and [[Vermillion border|vermillion]] zone of the lips.
Intraorally
* [[Buccal mucosa]]
* [[Tongue]]
* [[Labial]] [[mucosa]]
|
* Hemartomatous [[polyposis]] of the [[gastrointestinal tract]]
* [[Pancreatic cancer]]
* [[gastrointestinal tract cancer]]
|-
| colspan="2" |[[Neurofibromatosis]]<ref name="pmid21731277">{{cite journal |vauthors=Janardhanan M, Rakesh S, Vinod Kumar R |title=Intraoral presentation of multiple malignant peripheral nerve sheath tumors associated with neurofibromatosis-1 |journal=J Oral Maxillofac Pathol |volume=15 |issue=1 |pages=46–51 |date=January 2011 |pmid=21731277 |pmc=3125655 |doi=10.4103/0973-029X.80025 |url=}}</ref><ref name="pmid21977094">{{cite journal |vauthors=Thammaiah S, Manjunath M, Rao K, Uma DH |title=Intraoral plexiform neurofibroma involving the maxilla - pathognomonic of neurofibromatosis type I |journal=J Pediatr Neurosci |volume=6 |issue=1 |pages=65–8 |date=January 2011 |pmid=21977094 |pmc=3173921 |doi=10.4103/1817-1745.84413 |url=}}</ref>
|
* [[Nodular]] [[neurofibroma]]
* [[Macroglossia]]
* Enlargement of [[filiform papillae]]
|
* [[Tongue]]
* [[Lips]]
* [[Palate]]
* [[Buccal mucosa]]
* [[Gingiva]]
* Floor of the mouth or the [[pharynx]]
|
* [[Café au lait spot|Cafe au lait]] [[macules]]
* Freckling in the [[axillary]] or [[inguinal]] regions (Crowe´s sign)
* [[Optic glioma]]
* [[Lisch nodules]] ([[iris]] [[hamartomas]])
* [[Sphenoid]] [[dysplasia]]
* A first-degree relative
|-
| colspan="2" |[[Polyostotic fibrous dysplasia]]<ref name="pmid23953425">{{cite journal |vauthors=Akintoye SO, Boyce AM, Collins MT |title=Dental perspectives in fibrous dysplasia and McCune-Albright syndrome |journal=Oral Surg Oral Med Oral Pathol Oral Radiol |volume=116 |issue=3 |pages=e149–55 |date=September 2013 |pmid=23953425 |pmc=3851571 |doi=10.1016/j.oooo.2013.05.023 |url=}}</ref>
|
* Orofacial deformity
* [[Dental]] disorders
* [[Bone]] pains
* Compromised oral health
|
|
* [[McCune-Albright syndrome]]
|-
| colspan="2" |[[Smoker's melanosis]]<ref name="pmid25954535">{{cite journal |vauthors=Monteiro LS, Costa JA, da Câmara MI, Albuquerque R, Martins M, Pacheco JJ, Salazar F, Figueira F |title=Aesthetic Depigmentation of Gingival Smoker's Melanosis Using Carbon Dioxide Lasers |journal=Case Rep Dent |volume=2015 |issue= |pages=510589 |date=2015 |pmid=25954535 |pmc=4410537 |doi=10.1155/2015/510589 |url=}}</ref><ref name="pmid26528364">{{cite journal |vauthors=Moravej-Salehi E, Moravej-Salehi E, Hajifattahi F |title=Relationship of Gingival Pigmentation with Passive Smoking in Women |journal=Tanaffos |volume=14 |issue=2 |pages=107–14 |date=2015 |pmid=26528364 |pmc=4629424 |doi= |url=}}</ref><ref name="pmid1920020">{{cite journal |vauthors=Brown FH, Houston GD |title=Smoker's melanosis. A case report |journal=J. Periodontol. |volume=62 |issue=8 |pages=524–7 |date=August 1991 |pmid=1920020 |doi=10.1902/jop.1991.62.8.524 |url=}}</ref>
|
* Irregular [[macular]] [[hyperpigmentation]] of the [[oral mucosa]].
* Brown patches
|
* [[Mandibular]] anterior [[gingiva]] in cigarette smokers
* [[Buccal mucosa]] in pipe smokers.
* [[Hard palate]] in those who engage in reverse smoking
|
* [[Smoking]]
|-
| colspan="2" |[[Amalgam]] [[Tattoo]]<ref name="pmid23533829">{{cite journal |vauthors=Lundin K, Schmidt G, Bonde C |title=Amalgam tattoo mimicking mucosal melanoma: a diagnostic dilemma revisited |journal=Case Rep Dent |volume=2013 |issue= |pages=787294 |date=2013 |pmid=23533829 |pmc=3606745 |doi=10.1155/2013/787294 |url=}}</ref><ref name="pmid6928285">{{cite journal |vauthors=Buchner A, Hansen LS |title=Amalgam pigmentation (amalgam tattoo) of the oral mucosa. A clinicopathologic study of 268 cases |journal=Oral Surg. Oral Med. Oral Pathol. |volume=49 |issue=2 |pages=139–47 |date=February 1980 |pmid=6928285 |doi= |url=}}</ref>
|
* Blue-black [[macules]]
|
* [[Gingival]] margin or proximal [[buccal mucosa]] near [[amalgam]] dental fillings
|
* [[Dental]] [[Implant]] [[surgery]]
|}
<div style="width: 70%;">
<small><small></small></small>
{| class="wikitable"
|-
! colspan="6" |Vesicular/Ulcerative/Erythematous lesions
|-
! colspan="3" |Oral lesion
!Differentiating feature
!Location
!Associated Condition
|-
| rowspan="3" |Hereditary
| rowspan="3" |[[Epidermolysis bullosa]]<ref name="pmid19945630">{{cite journal |vauthors=Wright JT |title=Oral manifestations in the epidermolysis bullosa spectrum |journal=Dermatol Clin |volume=28 |issue=1 |pages=159–64 |date=January 2010 |pmid=19945630 |pmc=2787479 |doi=10.1016/j.det.2009.10.022 |url=}}</ref><ref name="pmid23349175">{{cite journal |vauthors=Parushetti AD, Agrawal JM, Nanjannawar LG, Agrawal MS |title=Oral manifestations of epidermolysis bullosa dystrophica: a rare genetic disease |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=January 2013 |pmid=23349175 |pmc=3604461 |doi=10.1136/bcr-2012-007963 |url=}}</ref><ref name="pmid26604545">{{cite journal |vauthors=Scheidt L, Sanabe ME, Diniz MB |title=Oral Manifestations and Dental Management of Epidermolysis Bullosa Simplex |journal=Int J Clin Pediatr Dent |volume=8 |issue=3 |pages=239–41 |date=2015 |pmid=26604545 |pmc=4647048 |doi=10.5005/jp-journals-10005-1321 |url=}}</ref><ref name="pmid27041842">{{cite journal |vauthors=Kudva P, Jain R |title=Periodontal manifestation of epidermolysis bullosa: Looking through the lens |journal=J Indian Soc Periodontol |volume=20 |issue=1 |pages=72–4 |date=2016 |pmid=27041842 |pmc=4795140 |doi=10.4103/0972-124X.164760 |url=}}</ref>
|
* Epidermolysis bullosa simplex
|
* [[Autosomal dominant]]
* [[Intradermal]] blistering
* [[Skin lesions]] usually disappear without [[scarring]]
|
| rowspan="3" |
* [[Pyloric Stenosis|Pyloric]] atresia
* Other congenital abnormalities of the [[gastrointestinal]] and [[genitourinary]] tract
|-
|Junctional epidermolysis bullosa
|
* [[Autosomal recessive]]
* Separation of [[lamina lucida]] at the dermo-epidermal junction
* Involvement of [[oral mucosa]], [[Alopecia]] and [[anonychia]] are frequent
|
|-
|Dystrophic epidermolysis bullosa
|
* [[Autosomal dominant]] or [[recessive]]
* Defective anchoring fibrils resulting in separation of sub-basal lamina
* [[Blisters]] results in dystrophic lesions
* Millium formation due to damaged [[hair follicles]]
|
|-
| rowspan="7" |Autoimmune
|[[Pemphigus vulgaris]]<ref name="pmid26949302">{{cite journal |vauthors=Arpita R, Monica A, Venkatesh N, Atul S, Varun M |title=Oral Pemphigus Vulgaris: Case Report |journal=Ethiop J Health Sci |volume=25 |issue=4 |pages=367–72 |date=October 2015 |pmid=26949302 |doi= |url=}}</ref><ref name="pmid27721634">{{cite journal |vauthors=Kumar SJ, Nehru Anand SP, Gunasekaran N, Krishnan R |title=Oral pemphigus vulgaris: A case report with direct immunofluorescence study |journal=J Oral Maxillofac Pathol |volume=20 |issue=3 |pages=549 |date=2016 |pmid=27721634 |doi=10.4103/0973-029X.190979 |url=}}</ref><ref name="pmid23493851">{{cite journal |vauthors=Rath SK, Reenesh M |title=Gingival pemphigus vulgaris preceding cutaneous lesion: A rare case report |journal=J Indian Soc Periodontol |volume=16 |issue=4 |pages=588–91 |date=October 2012 |pmid=23493851 |pmc=3590732 |doi=10.4103/0972-124X.106922 |url=}}</ref>
| colspan="2" |
* Superficial [[ulcers]] to small [[vesicles]] or [[blisters]].
* In the [[oral cavity]], the bubbles rapidly break, leaving a painful [[Erosion (dental)|erosion]] producing burning sensation.
* The size of the ulcers is extremely variable.
* [[Nikolsky's sign]]
|
* [[Buccal mucosa]]
* [[Soft palate]]
* [[Lower lip]]
* [[Tongue]]
* Less frequently, at the [[gingiva]]
|
* [[Inflammatory bowel disease]]
* [[Rheumatoid arthritis]]
|-
|[[Mucous membrane pemphigoid]] (Cicatricial pemphigoid)<ref name="pmid27563211">{{cite journal |vauthors=Vijayan V, Paul A, Babu K, Madhan B |title=Desquamative gingivitis as only presenting sign of mucous membrane pemphigoid |journal=J Indian Soc Periodontol |volume=20 |issue=3 |pages=340–3 |date=2016 |pmid=27563211 |doi=10.4103/0972-124X.182602 |url=}}</ref><ref name="pmid20161882">{{cite journal |vauthors=Trimarchi M, Bellini C, Fabiano B, Gerevini S, Bussi M |title=Multiple mucosal involvement in cicatricial pemphigoid |journal=Acta Otorhinolaryngol Ital |volume=29 |issue=4 |pages=222–5 |date=August 2009 |pmid=20161882 |pmc=2816372 |doi= |url=}}</ref><ref name="pmid19905946">{{cite journal |vauthors=Schellinck AE, Rees TD, Plemons JM, Kessler HP, Rivera-Hidalgo F, Solomon ES |title=A comparison of the periodontal status in patients with mucous membrane pemphigoid: a 5-year follow-up |journal=J. Periodontol. |volume=80 |issue=11 |pages=1765–73 |date=November 2009 |pmid=19905946 |doi=10.1902/jop.2009.090244 |url=}}</ref><ref name="pmid27563211">{{cite journal |vauthors=Vijayan V, Paul A, Babu K, Madhan B |title=Desquamative gingivitis as only presenting sign of mucous membrane pemphigoid |journal=J Indian Soc Periodontol |volume=20 |issue=3 |pages=340–3 |date=2016 |pmid=27563211 |pmc=4976558 |doi=10.4103/0972-124X.182602 |url=}}</ref>
| colspan="2" |
* [[Desquamative gingivitis]]
* The lesions show as simple [[erythema]] or true [[ulcerations]] affecting both the fixed [[gingiva]] and the adherent [[gingiva]].
* The symptoms associated with these conditions go from burning sensation and bleeding to [[mastication]] impairment
* [[Pemphigoid]] [[blisters]] are less brittle than those seen in [[pemphigus]]
* Remain intact in the [[oral cavity]] for up to 48 hours
|
* [[Gingiva]]
* [[Buccal mucosa]]
* [[Palate]]
|
* [[Hypothyroidism]]
|-
|[[Lupus erythematosus]]<ref name="pmid18254558">{{cite journal |vauthors=Sverzut AT, Allais M, de Maurette MA, Mazzonetto R, de Moraes M, Passeri LA, Moreira RW |title=Oral manifestation of systemic lupus erythematosus: lupus nephritis--report of a case |journal=Gen Dent |volume=56 |issue=1 |pages=35–41 |date=2008 |pmid=18254558 |doi= |url=}}</ref><ref name="pmid23248469">{{cite journal |vauthors=Ranginwala AM, Chalishazar MM, Panja P, Buddhdev KP, Kale HM |title=Oral discoid lupus erythematosus: A study of twenty-one cases |journal=J Oral Maxillofac Pathol |volume=16 |issue=3 |pages=368–73 |date=September 2012 |pmid=23248469 |pmc=3519212 |doi=10.4103/0973-029X.102487 |url=}}</ref><ref name="pmid22888407">{{cite journal |vauthors=Uva L, Miguel D, Pinheiro C, Freitas JP, Marques Gomes M, Filipe P |title=Cutaneous manifestations of systemic lupus erythematosus |journal=Autoimmune Dis |volume=2012 |issue= |pages=834291 |date=2012 |pmid=22888407 |doi=10.1155/2012/834291 |url=}}</ref>
| colspan="2" |Classical clinical manifestation is represented by a regular:
* Round or slightly red irregular area
* [[Atrophy]] or the presence of [[ulceration]]
* The red area is characterized by typical white radiating [[striae]] and [[Telangiectasias|telangiectasia]].
* Lack of [[symmetry]] 
* [[Petechial]] lesion
* [[Gingival bleeding]] such as [[desquamative gingivitis]], [[Marginal distribution|marginal]] [[gingivitis]], or erosive [[mucosal]]
|
|
|-
|[[Aphthous ulcer]]<ref name="pmid25346356">{{cite journal |vauthors=Altenburg A, El-Haj N, Micheli C, Puttkammer M, Abdel-Naser MB, Zouboulis CC |title=The treatment of chronic recurrent oral aphthous ulcers |journal=Dtsch Arztebl Int |volume=111 |issue=40 |pages=665–73 |date=October 2014 |pmid=25346356 |pmc=4215084 |doi=10.3238/arztebl.2014.0665 |url=}}</ref><ref name="pmid26880080">{{cite journal |vauthors=Vaillant L, Samimi M |title=[Aphthous ulcers and oral ulcerations] |language=French |journal=Presse Med |volume=45 |issue=2 |pages=215–26 |date=February 2016 |pmid=26880080 |doi=10.1016/j.lpm.2016.01.005 |url=}}</ref><ref name="pmid16449028">{{cite journal |vauthors=Bucci P, Carile F, Sangianantoni A, Sangianantoni A, D'Angiò F, Santarelli A, Lo Muzio L |title=Oral aphthous ulcers and dental enamel defects in children with coeliac disease |journal=Acta Paediatr. |volume=95 |issue=2 |pages=203–7 |date=February 2006 |pmid=16449028 |doi=10.1080/08035250500355022 |url=}}</ref>
| colspan="2" |
* Shallow, round to oval [[ulcer]] with white or yellow pseudomembrane surrounded by [[erythematous]] [[Halo sign|halo]]
* In chronic [[ulcer]] grey membrane may replace the yellow pseudomembrane
|
* Non-keratinized [[oral mucosa]] along the [[labial]] or [[buccal]] surfaces, [[soft palate]], floor of the [[mouth]], ventral or lateral surface of the [[tongue]] and [[oropharynx]]
|
|-
|[[Erythema multiforme]]<ref name="pmid17767983">{{cite journal |vauthors=Scully C, Bagan J |title=Oral mucosal diseases: erythema multiforme |journal=Br J Oral Maxillofac Surg |volume=46 |issue=2 |pages=90–5 |date=March 2008 |pmid=17767983 |doi=10.1016/j.bjoms.2007.07.202 |url=}}</ref><ref name="pmid22434953">{{cite journal |vauthors=Joseph TI, Vargheese G, George D, Sathyan P |title=Drug induced oral erythema multiforme: A rare and less recognized variant of erythema multiforme |journal=J Oral Maxillofac Pathol |volume=16 |issue=1 |pages=145–8 |date=January 2012 |pmid=22434953 |pmc=3303512 |doi=10.4103/0973-029X.92995 |url=}}</ref>
| colspan="2" |
* [[Prodromal]] [[skin]] target lesions, bullae and [[ulcerations]] with irregular borders and [[inflammatory]] halos, bloody encrustations on the [[lips]]
|
* [[Lips]]
* [[Buccal mucosa]]
* [[Tongue]]
|
|-
|[[Sjogren's Syndrome]]
| colspan="2" |Affects salivary and [[lacrimal glands]]
* Dryness in the mouth ([[xerostomia]])
* Deficiency of tears causes [[xerophthalmia]]
* Lack of [[saliva]] predisposes patients to develop tooth cavities.
* Accumulation of [[Plaques|plaque]]
* [[Edema]] and inflammations of the [[gingiva]] are frequent clinical signs. Moreover, a salivary flow decrease can develop [[opportunistic infections]].
|
* [[Gingiva]]
* [[Parotid gland]]
* [[Tooth]]
|
|-
|[[Bullous pemphigoid]]
| colspan="2" |
* Discrete [[Vesicles|vesicle]] formation with Multiple [[ulcers]]
* [[Desquamative gingivitis]] as the most common presentation
|
* [[Gingiva]]
|
|-
| rowspan="4" |Idiopathic
|[[Erythroplakia]]
| colspan="2" |
|
|
|-
| rowspan="2" |Contact stomatitis
|Irritant contact stomatitis
| rowspan="2" |Microscopic features:
* [[Oral mucosa]] may appear acanthotic, hyperkeratotic with elongated rete ridges
* [[Lamina propria]] infiltrated by [[lymphocytes]], [[plasma cells]], [[histiocytes]] and [[eosinophils]]
* Hallmark of ICD is perturbation of the skin barrier and [[epidermal]] regenerative hyperproliferation
* Hallmark of ACD is spongiosis
Clinical manifestations may incude
* [[Erythema]], [[Vesicles|vesicle]] formation, [[Erosion (dental)|erosion]], [[ulcer]] formation and shaggy [[hyperkeratosis]]
| rowspan="2" |
* Oral cavity: commonly sides of the [[tongue]], [[gums]], [[hard palate]] and [[buccal mucosa]]
|
|-
|Allergic contact stomatitis
|
|-
|Medication induced stomatitis
| colspan="2" |
|
|
|-
|}
{| class="wikitable"
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Type of cancer
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Subtype
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Epidemiology
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Localization
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Clinical features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Diagnostic procedures
|-
|[[Squamous cell carcinoma]]
*Basaloid squamous cell carcinoma
*Papillary squamous cell carcinoma
*Spindle cell carcinoma
*Acantholytic squamous cell carcinoma
*[[Adenosquamous carcinoma]]
|[[Verrucous carcinoma]]
|
*Older males
*5th and 6th decades of life
*Males  are  affected  more  often  than females
|
*Lip  SCC  arise  almost  exclusively  on the  lower  lip
*[[Buccal  mucosa]]
*Upper  and lower  [[gingiva]]
*[[Hard  palate]]
*Anterior  two-thirds  of  the  [[tongue]],  including  dorsal, ventral and lateral surfaces, and the floor of mouth
|
*Often asymptomatic or may  present  with  vague  symptoms  and  minimal  physical  finding
|Biopsy shows:
Thickened  club-shaped
[[papillae]]  and  blunt  stromal  invaginations
of  well-differentiated  [[squamous  epithelium]] with marked [[keratinization]]
|-
|[[Lymphoepithelioma|Lymphoepithelial carcinoma]]
|
|0.8-2%  of  all  oral  or  oropharyngeal cancers
|
*[[Tonsil]]  and  [[tongue]](90%)
*[[Palate]]  and  [[buccal  mucosa]](others)
|
*Intraoral mass,  which  may  be  [[Ulcerated lesion|ulcerated]].
*Some tumors  can  be  bilateral
|Biopsy chows:
*Syncytial sheets and  clusters  of  [[Carcinoma|carcinoma  cells]]  with [[Vesicular|vesicular  nuclei]]
*Prominent  [[nucleoli]]  and ill-defined  cell  borders
*A  rich  [[Lymphoplasmacytic lymphoma|lymphoplasmacytic]] infiltrate is present
|-
|[[Epithelial cells|Epithelial precursor]] lesions
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|Seen in the entire [[digestive tract]]
|
*White  patches  ([[leukoplakia]])
*Red patches  ([[Erythroplasia of Queyrat|erythroplasia]]/[[erythroplakia]])
*Mixed red and white lesions
|Biopsy shows:
*[[Hyperplasia]]
*[[Dysplasia]],  /  squamous  intraepithelial  neoplasia / [[Hyperplasia|atypical hyperplasia]]
*[[Carcinoma in situ|Carcinoma in-situ]]
|-
|Proliferative verrucous leukoplakia and [[Premalignant condition|precancerous conditions]]
|<nowiki>---</nowiki>
|
*Average age at diagnosis is 62 years
*Women are  more  commonly  afflicted  (ratio,  4:1)
|
*[[Buccal  mucosa]] in women
*[[Tongue]]  in  men.
|An  aggressive  form  of  [[oral  leukoplakia]]  with  considerable  morbidity  and
strong  predilection  to  [[malignant  transformation]]
|Biopsy shows:
*Extensive, thick, white plaques
*[[Hyperplasia]] and dense [[hyperkeratosis]]
*[[Verrucous carcinoma|Verrucous]] surface with [[hyperkeratosis]], [[hypergranulosis]] and a dense inflammatory infiltrate in the [[corium]]
|-
| rowspan="3" |[[Papillomas]]
|[[Squamous cell papilloma]] and
[[verruca vulgaris]]
|
*Common  in children  and  in  adults  in  the  3rd  to  5th decades
*Almost  equal  sex  incidence with a slight male predominance
|Any oral site may be affected mostly:
*[[Hard palate|Hard]]  and  [[soft  palate]]
*[[Labial]] [[Mucous membrane|mucosa]]
*[[Tongue]]
*[[Gingiva]]
|Soft, [[Pedunculated|pedunculated  lesions]]  formed  by  a  cluster  of  finger-like  fronds  or  a  [[sessile]],  dome-shaped lesion with a [[nodular]], [[papillary]] or [[Verrucous carcinoma|verrucous]]  surface
|Biopsy shows:
*Exophytic  and  comprise folds of [[hyperplastic]] [[stratified epithelium]]
*Cluster  of  finger-like  projections
|-
|[[Condyloma acuminatum]]
|2nd and 5th decade with a peak in teenagers and young adults
|
*[[Labial]] [[mucosa]]
*[[Tongue]]
*[[Palate]]
|
*Painless,  rounded, dome-shaped  exophytic  [[nodules]]
*15 mm  in  diameter
*Have a broad base and a [[nodular]] or mulberry-like  surface  that  is  slightly  red, pink  or  of  normal  [[Mucous membrane|mucosal]]  color.
*Lesions  may  be  multiple  and  are  then usually clustered
|Biopsy shows:
Several [[sessile]], [[Cauliflower ear|cauliflower]]-like swellings forming a cluster
|-
|[[Focal epithelial hyperplasia]]
|[[Disease]] of children, adolescents and young adults
|
*All areas of the [[oral cavity]]
*[[Labia]]
*[[Buccal  mucosa]]
*[[Tongue]]
|
*Multiple  asymptomatic [[lesions]]
*Soft rounded or flat plaque-like [[sessile]] swelling.
*Usually pink or white in color
*2-10mm  in  diameter
|Biopsy shows:
*Rounded  [[sessile]]  swelling formed by a sharply demarcated zone of [[epithelial]]  acanthosis
*[[Koilocyte|Koilocytes]]  similar  to  those  of  squamous papilloma  are  usually  present
*“Mitosoid  bodies”,  which  are  [[nuclei]]  with coarse clumped [[heterochromatin]] resembling a mitotic figure
|-
|[[Granular cell tumor]]
|<nowiki>---</nowiki>
|
*Arise in all  age groups, with a peak between 40 and 60 years
*Females  are  affected  more  often  than  males  with  an  M/F ratio of 2:1
|
*[[Tongue]]  is  the  most  common  single site
*[[Buccal mucosa]]
*Floor of oral cavity
*[[Palate]]
*[[Salivary gland]]
|
*Lesion presents  as  a smooth, [[sessile]] [[Mucous membrane|mucosal swelling]]
*1-2 cm in diameter with a firm texture.
*The overlying  [[epithelium]]  is  of  normal  color  or may  be  slightly  pale
|Biopsy shows:
*Plump [[eosinophilic]] cells with central small dark nuclei and abundant [[Cytoplasm|granular cytoplasm]]
|-
|[[Keratoacanthoma]]
|<nowiki>---</nowiki>
|
*Occurs  more  often  in
whites
*Twice as frequent in
men  as  in  women
|
*[[Skin]] of the face,including  the  [[lips]]
*[[Mucocutaneous|Mucocutaneous  linings]]  may  also  be involved
|
*[[Verrucous carcinoma|Verrucous]],  speckled or [[Ulcerated lesion|ulcerated lesions]]
*Deep  projections,  which extend through [[Salivary gland tumor|minor salivary glands]] and underlying bone
|Biopsy shows:
*[[Verrucous carcinoma|Verrucous]] surface,  [[keratinized]] clefts  and  penetrating  squamous  [[Rete pegs|rete processes]]
*Minimal [[atypia]] seen
|-
|[[Papillary|Papillary hyperplasia]]
|<nowiki>---</nowiki>
|Affects all age groups
|[[Palate]]
|Asymptomatic [[nodular]]  or  [[Papillary|papillary  mucosal  lesion]]
|Biopsy shows:
*Parakeratinisation  or  less  frequently orthokeratinisation
|-
|Median rhomboid glossitis
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|Dorsum  of  the  tongue at  the  junction  of  the  anterior  two  thirds
and  posterior  third
|Forms  a  patch  of  papillary  atrophy  in  the  region  of  the
embryological  [[Foramen cecum|foramen  caecum]]
|Biopsy shows:
*[[Psoriasis|Psoriasiform]] [[hyperplasia]]
*Areas  of  pseudoepitheliomatous  [[hyperplasia]]
*[[Atypia]]  may  be present
|-
| rowspan="8" |[[Salivary gland tumor|Salivary gland tumors]]
|[[Acinic cell carcinoma]]
|
*2-6.5%  of  all  intraoral  [[Salivary gland tumor|salivary  gland tumors]]
*Age range from 11-77 years, with a mean of 45 years
*Male to female ratio  of  1.5:1
|
*[[Buccal  mucosa]]
*[[Upper  lip]] and
*[[Palate]]
|[[Tumors]]  usually
form non-descript  swellings
|Biopsy shows:
*Solid  sheets  of  [[epithelium]]  with secretory material
*Ductal differentiation in [[tumors]]
|-
|[[Mucoepidermoid carcinoma]]
|
*9.5-23%  of  all  minor  gland tumors
|
*[[Palate]] (most common site)
*[[Buccal mucosa]]
*[[Lips]]: upper>lower
*Floor  of  [[oral  cavity]]
*Retromolar pad
|
*Asymptomatic
*Bluish,  domed  swellings  that  resemble  mucoceles  or [[Hemangioma|haemangiomas]]
*High-grade  tumors result in  [[ulceration]], loosening of teeth, [[Paresthesia|paraesthesia]] or [[Anesthesia|anaesthesia]]
|Low power [[microscopy]] shows low-grade tumor with both [[cystic]] and solid areas and an inflamed, fibrous stroma
|-
|Adenoid cystic carcinoma
|
*42.5% of minor gland tumors
*
|
*[[Tongue]]
*[[Tonsil]]
*[[Oropharynx]]
*[[Cheek]]
*[[Lips]]
*Retromolar  pad  and  [[gingiva]]
|
*Slow growing [[Submucosa|submucosal]] masses and [[ulceration]]  may  be  seen,  particularly  in  the [[palate]]
*[[Pain]],  or  evidence  of  [[Nerve|nerve  involvement,]]  is  usually  only  present  in advanced  tumors
|Predominantly solid variant shows peri- and intraneural invasion
|-
|Epithelial-myoepithelial
carcinoma
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|-
|[[Clear cell tumor|Clear cell carcinoma,]]
NOS
|
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|-
|[[Basal cell carcinoma|Basal cell]]
[[Basal cell carcinoma|adenocarcinoma]]
|Rare in minor glands
|
*[[Palate]]
*[[Buccal  mucosa]]
*[[Lip]]
|Asymptomatic, smooth or lobulated [[Submucosa|sub-mucosal  masses]]
|Microscopically similar to [[Basal cell carcinoma|basal]]
[[Basal cell carcinoma|cell  adenocarcinomas]]  of  the  major gland
|-
|[[Cystadenocarcinoma]]
|32%  developed  in  the  minor  glands
|
*[[Palate]]
*[[Lips]]
*[[Buccal  mucosa]]
*[[Tongue]] and  retromolar  regions
|Slow  growing  and  painless  but
some  [[palatal]]  [[tumors]]  may erode  the
underlying    bone    causing sinonasal  complex
|<nowiki>---</nowiki>
|-
|Salivary duct carcinoma
|
*Rare  in  minor  salivary glands
*Age  range  was  23-80  years  (mean  56 years)
|
*[[Palate]]  (65%)
*[[Buccal  mucosa]] and  [[vestibule]]  (19%)
*[[Tongue]]  (8%)
*Retromolar  pad  (4%)  and  [[upper  lip]]  (4%)
|[[Tumor|Tumors]]  formed  painless swellings  but  many  in  the  [[palate]]  can be painful and [[Ulcerated lesion|ulcerated]] or fungated with [[Metastasis|metastases]] to [[Lymph nodes|regional lymph nodes]]
|The  range  of
microscopical  appearances  is  similar
to that seen in the major glands
|-
| rowspan="4" |[[Salivary gland cancer|Salivary gland adenomas]]
|[[Pleomorphic adenoma]]
|40-70% of minor gland tumors
|
*[[Palate]]
*[[Lips]]  and
*[[Buccal  mucosa]]
|Painless,  slow growing,  [[Submucosa|submucosal]]  masses,  but  when
traumatized  may  [[bleed]]  or  [[Ulcer|ulcerate]]
|Biopsy shows cellular, and [[hyaline]] or [[plasmacytoid]] cell
|-
|Myoepithelioma
|42% of minor gland tumors
|
*[[Palate]] of younger individuals
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|-
|Basal cell adenoma
|20% of minor gland tumors
|
*[[Upper  lip]]
*[[Buccal  mucosa]]
|<nowiki>---</nowiki>
|They  are  histologically
similar to those in major glands.
|-
|[[Cystadenoma]]
|7% of benign minor gland tumors
|
*[[Lips]]
*[[Cheek]]
*[[Palate]]
|<nowiki>---</nowiki>
|<nowiki>---</nowiki>
|-
|[[Kaposi's sarcoma|Kaposi sarcoma]]
|<nowiki>---</nowiki>
|
*Classic (elderly  men  of  Mediterranean/EastEuropean  descent)
*[[Endemic]] ( middle-aged  adults and children in Equatorial Africa who are not  [[HIV infected adolescents|HIV  infected]])
*[[Iatrogenic]] ([[Immunosuppressed]], post-transplant)
*[[AIDS associated Kaposi sarcoma|AIDS associated]] ([[HIV-1 protease|HIV-1]] infected individuals)
|
*[[Skin]] ( most common)
*[[Mucous membrane|Mucosal  membranes]]  such  as  [[oral  mucosa]],  [[lymph nodes]]  and  [[Visceral organ|visceral  organs]]
|
*Purplish,  reddish  blue  or dark  brown  [[macules]]
*[[Plaques]]  and  [[nodules]]  that  may  [[Ulcerated lesion|ulcerate]]
|Biopsy of all 4 types show:
*[[Vascular|Vascular slits]] and sparsely distributed [[Lymphocyte|lymphocytes]]
|-
|[[Lymphangioma]]
|<nowiki>---</nowiki>
|
*[[Pediatric Oncology Group|Pediatric lesions]]
*Present at birth or    during    the    first    years    of    life
*Appear  mostly  in  the head and neck area but may be found in any other part of the body
|[[Tongue]]
|
*Circumscribed  painless  swelling
*Soft  and  fluctuant  on  palpation
*Irregular  nodularity  of  the  dorsum  of  the  [[tongue]]
|Biopsy shows:
*Thin-walled,  dilated  [[lymphatic  vessels]]  of different  size,  which  are  lined  by  a  flattened [[endothelium]]
|-
|Ectomesenchymal chondromyxoid
tumour of the anterior tongue
|<nowiki>---</nowiki>
|
*Age range  varies  from  9-78  years
*No distinct sex predilection.
|<nowiki>---</nowiki>
|Asymptomatic, slow growing solitary nodule in the anterior dorsal tongue
|Biopsy shows:
*Round, cup-shaped, [[fusiform]], or polygonal  cells  with  uniform  small  [[nuclei]] and    moderate    amounts    of    [[Basophilic|faintly basophilic cytoplasm]]
*Some tumors may show  nuclear  pleomorphism,  hyperchromatism, and multinucleation
|-
|Focal oral mucinosis (FOM)
|<nowiki>---</nowiki>
|
*The  lesion  affects  all ages
*Rare  in  children
*There is no distinct sex predilection.
|
*[[Gingiva]]( most common site)
*[[Palate]]
*Cheek  [[mucosa]]  and
*[[Tongue]]
|Asymptomatic  fibrous  or cystic-like lesion
|Histopathology is characterized by:
*Well-circumscribed  area  of  [[myxomatous]] tissue
*[[Fusiform]] or [[Stellate cell|stellate]] [[fibroblasts]]
*Absent or sparse [[reticular  fibers]]
*[[Mucinous]] material  shows  alcianophilia  at  pH  2.5
|-
|Congenital granular cell epuli
|<nowiki>---</nowiki>
|
*Affects newborns
*Females are affected ten times more often than males
|
*[[Maxilla]]
*[[Mandible]]
|[[Solitary]],  somewhat  [[pedunculated]]  fibroma-like  lesion  attached  to  the  alveolar
ridge  near  the  midline
|
*Ultrasound for prenatal diagnosis
*Immuno  histochemically,  the tumor cells are positive for [[vimentin]]  and  neuron  specific  [[enolase]]
*No reactivity  with  [[cytokeratin]],  [[CEA]],  [[desmin]], hormone  receptors  or  [[S-100]]
|-
| rowspan="5" |Hematolymphoid tumors
|[[Non-Hodgkin lymphoma]]
|Second  most  common  cancer  of  the  [[oral  cavity]]
|
*[[Palate]]
*[[Tongue]]
*Floor  of  mouth
*[[Gingiva]]
*[[Buccal mucosa]]
*[[Lips]]
*[[Palatine tonsils]]
*[[Lingual tonsils]] or
*[[Oropharynx]]
|[[Non-Hodgkin lymphoma|NHL]]  of  the  [[lip]] presents with:
*[[Ulcer]]
*[[Swelling]]
*[[Discolored tongue|Discoloration]]
*[[Pain]]
*[[Paresthesia|Paraesthesia]]
*[[Anesthesia|Anaesthesia]],  or
*Loose  teeth
|Biopsy shows:
*Large cells with predominantly round nuclei and membrane-bound nucleoli, consistent with centroblastic morphology.
*Predominantly medium-sized cells with abundant pale [[cytoplasm]].
*Large cells with round or multilobated nuclei
|-
|[[Langerhans cell histiocytosis]]
|<nowiki>---</nowiki>
|
*Jaw  bone
*Intraoral soft tissues
*[[Gingiva]]
*[[Palate]]
*Floor  of  mouth
*[[Buccal  mucosa]]
and
*[[Tonsil cancer|Tonsil]]
|Common  oral  symptoms
include:
*[[Swelling]]
*[[Pain]]
*[[Gingivitis]]
*Loose teeth  and
*[[Ulceration]]
|Biopsy shows ovoid  [[Langerhans  cells]]
with deeply grooved nuclei, thin nuclear membranes and abundant [[Eosinophilic|eosinophilic cytoplasm]]
|-
|[[Hodgkin's lymphoma|Hodgkin lymphoma]]
|<nowiki>---</nowiki>
|
*[[Waldeyer's ring|Waldeyer  ring,]]  particularly  the  [[palatine tonsil]]
*[[Oropharynx]]
*Alveolar  crest  of  [[mandible]]
*[[Maxillary bone|Maxillary  gingiva]]
|Most patients present with localized disease (stage I/II), with
*[[Chronic tonsillitis]] or [[Tonsillar abscess|tonsillar enlargement]] with or  without  enlarged  [[cervical  lymph nodes]]
|<nowiki>---</nowiki>
|-
|Extramedullary myeloid
sarcoma
|<nowiki>---</nowiki>
|
*[[Palate]]
*[[Gingiva]]
|Isolated tumor-forming intraoral mass
|Biopsy shows an Indian-file pattern of infiltration
|-
|[[Follicular dendritic cell]]
sarcoma / tumour
|
*Tumor of adulthood
*Affects wide age range
|
*[[Tonsil]]
*[[Palate]] or
*[[Oropharynx]].
|The  patients  usually
present  with  a  painless  mass
|Biopsy usually  exhibits
borders and comprises:
*[[Fascicles]]
*Whorls
*[[Nodules]]
*Storiform  arrays  or
*Diffuse sheets  of  spindly  to  ovoid  tumor  cells sprinkled  with  small  [[lymphocytes]]
|-
|Mucosal malignant melanoma
|<nowiki>---</nowiki>
|
*0.5%  of  oral  malignancies
*Incidence 0.02 per 100,000
|80%  arise:
*[[Palate]]
*Maxillary alveolus or [[Gingiva|gingivae]]
*Mandibular gingiva
Others:
*[[Buccal mucosa]]
*Floor of mouth
*[[Tongue]]
|
*Asymmetric with  irregular  outlines
*Macular  pigmentation
*Nodular growth
*[[Ulceration]]
*[[Melanosis]]
|
*Biopsy:
*S100  positive
*Negative  for  cytokeratins
*More  specific  markers  include:
*HMB45,
*Melan-A  or  anti-tyrosinase
|-
| colspan="2" |Hypopharyngeal Cancer
|
* [[Tobacco]] use.
* Abuse of [[alcohol]] consumption
* 7% of all cancers of [[head]] and [[neck]]
* 1 per 100,000 individuals
* Males are commonly affected with a hypopharyngeal cancer compared to females.
|
|
|
|}
<references />

Latest revision as of 19:59, 11 February 2019

Oral lesion Differentiating feature Location Associated condition
White lesions
Benign migratory glossitis[1][2][3]
  • Red patches with white distinct border
  • Map like appearance
Dorsal/Lateral surface of the tongue
Hairy tongue[4][5][6][7]
  • Elongated filliform lingual papilae
  • Carpet-like appearance
Dorsum of the tongue
Leukoedema[8][9]
  • White or whitish-gray edematous lesion
  • Diffuse or patchy
Buccal and labial oral mucosa
White sponge nevus[10][11]
  • White patches of tissue (nevi)
  • Singular or multiple
  • Thickened, velvety, sponge-like appearance
The moist lining of the oral mucosa buccal mucosa
Hairy leukoplakia[12][13]
  • White patches
    • Corrugated in appearance
    • Hairy, hair-like growths
    • Permanent
Oral lichen planus[14][15]
  • Reticular or papular lace like white lesions
  • Multiple, Painful
Nicotinic stomatitis[16][17]
  • Reddened area and slowly progresses to a white, thickened, and fissured
  • White cobblestone appearance
  • Red dot in the center
  • Cannot be wiped off
  • Painful
Smokers
Oral frictional hyperkeratosis[18][19]
  • White shaggy plaques
  • Could be easily peeled without any pain leaving normal mucosa
Fordyce granules[20][21][22][23]
  • White to yellow discrete papules,
  • 1 to 2 mm
  • Hereditary non-polyposis colorectal cancer
  • Muir-torre syndrome
Infectious oral Lesions
Disease Differentiating feautures Location Image
Herpes simplex virus infections[24][25][26] Herpetic gingivostomatitis
  • Painful ulcers covered by a yellowish pseudomembrane
  • Ulcers that may coalesce to form bigger lesions
  • Self limiting after 7 days
Keratinized and non-keratinized mucosa. Commonly seen on:
Herpes zoster[27][28][29]
  • Prodromal unilateral pain
  • Clustered small ulcers with characteristic unilateral pattern
  • Self limiting, heal within 10-14 days
Hand foot mouth disease[30][31][32]
  • Oval-shaped, pale papules with a rim of erythema
  • Small aphthae
Lesions spare the lips and gingiva, in contrast to HSV
Infectious mononucliosis[33][34] Pharyngitis
Erosive lichen planus[35][36][37]
Pseudomembranous candidiasis[38][39][40]
  • Known as thrush.
  • Usually asymptomatic.
  • Confluent white wipeable plaques resembling curdled milk
  • Superficially the plaques can be wiped off and the underlying mucosa often exhibits an erythematous appearance.
Histoplasmosis[41][42][43][44][45] Ohio and Mississippi river valleys
Blastomycosis[46][47][48] Mississippi, Missouri and Ohio River valleys and the Great lakes region.
Coccidiodomycosis[49][50][51][52] No specific location


Pigmented lesions
Oral lesion Differentiating feature Location Associated Condition
Physiologic[53][54]
Intravascular Hemangioma[55][56][57]
  • Red or bluish-red, slightly raised lesions
  • Rapidly during infancy and regress slowly during childhood
Kaposi sarcoma[58][59]
Extra-vascular Hematoma
Ecchymosis
Petechiae
Melanocytic Oral melanocytic macule[60][61]
  • Focal pigmented brown lesions similar to ephelides
  • Flat and mostly smaller than 1 cm
  • Characterised by a focal increase in melanin production
Oral melanoacanthoma[62][63][64]
Ephelis
  • Flat red or light brown spots
  • 3–10 mm in diameter
  • Poorly defined and may merge into large patches
Diffuse
Addison's disease[65][66]

Brown patches of

Peutz-Jeghers syndrome[67][68] Perioral
  • Freckling of the skin around lips and vermillion zone of the lips.

Intraorally

Neurofibromatosis[69][70]
Polyostotic fibrous dysplasia[71]
  • Orofacial deformity
  • Dental disorders
  • Bone pains
  • Compromised oral health
Smoker's melanosis[72][73][74]
Amalgam Tattoo[75][76]

Vesicular/Ulcerative/Erythematous lesions
Oral lesion Differentiating feature Location Associated Condition
Hereditary Epidermolysis bullosa[77][78][79][80]
  • Epidermolysis bullosa simplex
Junctional epidermolysis bullosa
Dystrophic epidermolysis bullosa
Autoimmune Pemphigus vulgaris[81][82][83]
Mucous membrane pemphigoid (Cicatricial pemphigoid)[84][85][86][84]
Lupus erythematosus[87][88][89] Classical clinical manifestation is represented by a regular:
Aphthous ulcer[90][91][92]
  • Shallow, round to oval ulcer with white or yellow pseudomembrane surrounded by erythematous halo
  • In chronic ulcer grey membrane may replace the yellow pseudomembrane
Erythema multiforme[93][94]
Sjogren's Syndrome Affects salivary and lacrimal glands
Bullous pemphigoid
Idiopathic Erythroplakia
Contact stomatitis Irritant contact stomatitis Microscopic features:

Clinical manifestations may incude

Allergic contact stomatitis
Medication induced stomatitis
Type of cancer Subtype Epidemiology Localization Clinical features Diagnostic procedures
Squamous cell carcinoma
  • Basaloid squamous cell carcinoma
  • Papillary squamous cell carcinoma
  • Spindle cell carcinoma
  • Acantholytic squamous cell carcinoma
  • Adenosquamous carcinoma
Verrucous carcinoma
  • Older males
  • 5th and 6th decades of life
  • Males are affected more often than females
  • Hard palate
  • Anterior two-thirds of the tongue, including dorsal, ventral and lateral surfaces, and the floor of mouth
  • Often asymptomatic or may present with vague symptoms and minimal physical finding
Biopsy shows:

Thickened club-shaped

papillae and blunt stromal invaginations

of well-differentiated squamous epithelium with marked keratinization

Lymphoepithelial carcinoma 0.8-2% of all oral or oropharyngeal cancers
  • Some tumors can be bilateral
Biopsy chows:
Epithelial precursor lesions --- --- Seen in the entire digestive tract Biopsy shows:
Proliferative verrucous leukoplakia and precancerous conditions ---
  • Average age at diagnosis is 62 years
  • Women are more commonly afflicted (ratio, 4:1)
An aggressive form of oral leukoplakia with considerable morbidity and

strong predilection to malignant transformation

Biopsy shows:
Papillomas Squamous cell papilloma and

verruca vulgaris

  • Common in children and in adults in the 3rd to 5th decades
  • Almost equal sex incidence with a slight male predominance
Any oral site may be affected mostly: Soft, pedunculated lesions formed by a cluster of finger-like fronds or a sessile, dome-shaped lesion with a nodular, papillary or verrucous surface Biopsy shows:
Condyloma acuminatum 2nd and 5th decade with a peak in teenagers and young adults
  • Painless, rounded, dome-shaped exophytic nodules
  • 15 mm in diameter
  • Have a broad base and a nodular or mulberry-like surface that is slightly red, pink or of normal mucosal color.
  • Lesions may be multiple and are then usually clustered
Biopsy shows:

Several sessile, cauliflower-like swellings forming a cluster

Focal epithelial hyperplasia Disease of children, adolescents and young adults
  • Soft rounded or flat plaque-like sessile swelling.
  • Usually pink or white in color
  • 2-10mm in diameter
Biopsy shows:
  • Rounded sessile swelling formed by a sharply demarcated zone of epithelial acanthosis
  • Koilocytes similar to those of squamous papilloma are usually present
Granular cell tumor ---
  • Arise in all age groups, with a peak between 40 and 60 years
  • Females are affected more often than males with an M/F ratio of 2:1
  • The overlying epithelium is of normal color or may be slightly pale
Biopsy shows:
Keratoacanthoma ---
  • Occurs more often in

whites

  • Twice as frequent in

men as in women

Biopsy shows:
Papillary hyperplasia --- Affects all age groups Palate Asymptomatic nodular or papillary mucosal lesion Biopsy shows:
  • Parakeratinisation or less frequently orthokeratinisation
Median rhomboid glossitis --- --- Dorsum of the tongue at the junction of the anterior two thirds

and posterior third

Forms a patch of papillary atrophy in the region of the

embryological foramen caecum

Biopsy shows:
Salivary gland tumors Acinic cell carcinoma
  • 2-6.5% of all intraoral salivary gland tumors
  • Age range from 11-77 years, with a mean of 45 years
  • Male to female ratio of 1.5:1
Tumors usually

form non-descript swellings

Biopsy shows:
  • Solid sheets of epithelium with secretory material
  • Ductal differentiation in tumors
Mucoepidermoid carcinoma
  • 9.5-23% of all minor gland tumors
Low power microscopy shows low-grade tumor with both cystic and solid areas and an inflamed, fibrous stroma
Adenoid cystic carcinoma
  • 42.5% of minor gland tumors
Predominantly solid variant shows peri- and intraneural invasion
Epithelial-myoepithelial

carcinoma

--- --- --- ---
Clear cell carcinoma,

NOS

--- --- ---
Basal cell

adenocarcinoma

Rare in minor glands Asymptomatic, smooth or lobulated sub-mucosal masses Microscopically similar to basal

cell adenocarcinomas of the major gland

Cystadenocarcinoma 32% developed in the minor glands Slow growing and painless but

some palatal tumors may erode the

underlying bone causing sinonasal complex

---
Salivary duct carcinoma
  • Rare in minor salivary glands
  • Age range was 23-80 years (mean 56 years)
Tumors formed painless swellings but many in the palate can be painful and ulcerated or fungated with metastases to regional lymph nodes The range of

microscopical appearances is similar

to that seen in the major glands

Salivary gland adenomas Pleomorphic adenoma 40-70% of minor gland tumors Painless, slow growing, submucosal masses, but when

traumatized may bleed or ulcerate

Biopsy shows cellular, and hyaline or plasmacytoid cell
Myoepithelioma 42% of minor gland tumors --- ---
Basal cell adenoma 20% of minor gland tumors --- They are histologically

similar to those in major glands.

Cystadenoma 7% of benign minor gland tumors --- ---
Kaposi sarcoma --- Biopsy of all 4 types show:
Lymphangioma ---
  • Appear mostly in the head and neck area but may be found in any other part of the body
Tongue
  • Circumscribed painless swelling
  • Soft and fluctuant on palpation
  • Irregular nodularity of the dorsum of the tongue
Biopsy shows:
Ectomesenchymal chondromyxoid

tumour of the anterior tongue

---
  • Age range varies from 9-78 years
  • No distinct sex predilection.
--- Asymptomatic, slow growing solitary nodule in the anterior dorsal tongue Biopsy shows:
Focal oral mucinosis (FOM) ---
  • The lesion affects all ages
  • Rare in children
  • There is no distinct sex predilection.
Asymptomatic fibrous or cystic-like lesion Histopathology is characterized by:
  • Mucinous material shows alcianophilia at pH 2.5
Congenital granular cell epuli ---
  • Affects newborns
  • Females are affected ten times more often than males
Solitary, somewhat pedunculated fibroma-like lesion attached to the alveolar

ridge near the midline

Hematolymphoid tumors Non-Hodgkin lymphoma Second most common cancer of the oral cavity NHL of the lip presents with: Biopsy shows:
  • Large cells with predominantly round nuclei and membrane-bound nucleoli, consistent with centroblastic morphology.
  • Predominantly medium-sized cells with abundant pale cytoplasm.
  • Large cells with round or multilobated nuclei
Langerhans cell histiocytosis ---
  • Jaw bone
  • Intraoral soft tissues
  • Gingiva

and

Common oral symptoms

include:

Biopsy shows ovoid Langerhans cells

with deeply grooved nuclei, thin nuclear membranes and abundant eosinophilic cytoplasm

Hodgkin lymphoma --- Most patients present with localized disease (stage I/II), with ---
Extramedullary myeloid

sarcoma

--- Isolated tumor-forming intraoral mass Biopsy shows an Indian-file pattern of infiltration
Follicular dendritic cell

sarcoma / tumour

  • Tumor of adulthood
  • Affects wide age range
The patients usually

present with a painless mass

Biopsy usually exhibits

borders and comprises:

  • Storiform arrays or
  • Diffuse sheets of spindly to ovoid tumor cells sprinkled with small lymphocytes
Mucosal malignant melanoma ---
  • 0.5% of oral malignancies
  • Incidence 0.02 per 100,000
80% arise:

Others:

  • Floor of mouth
  • Biopsy:
  • S100 positive
  • Negative for cytokeratins
  • More specific markers include:
  • HMB45,
  • Melan-A or anti-tyrosinase
Hypopharyngeal Cancer
  • Tobacco use.
  • Abuse of alcohol consumption
  • 7% of all cancers of head and neck
  • 1 per 100,000 individuals
  • Males are commonly affected with a hypopharyngeal cancer compared to females.
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