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Oral Pathology - 05 - Mucosal Premalignant Lesions

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Oral Pathology1

Clinical Categories and Classifications2

  • Developmental Conditions
  • Mucosal Lesions—Reactive
  • Mucosal Lesions—Infections
  • Mucosal Lesions—Immunologic Diseases
  • Mucosal Lesions—Premalignant
  • Mucosal Lesions—Malignant
  • CT Tumors—Benign
  • CT Tumors—Malignant
  • Salivary Gland Diseases—Reactive
  • Salivary Gland Diseases—Benign
  • Salivary Gland Diseases—Malignant
  • Lymphoid Neoplasms
  • Odontogenic Cysts
  • Odontogenic Tumors
  • Bone Lesions—Fibro-Osseous
  • Bone Lesions—Giant Cell
  • Bone Lesions—Inflammatory
  • Bone Lesions—Malignant
  • Hereditary Conditions

Premalignant Mucosal Lesions

Patients presenting with these lesions are at risk for developing cancer, specifically squamous cell carcinoma.

Leukoplakia Variations

Clinical Leukoplakia

Clinical Characteristics

  • Clinical description, not a diagnosis
  • White patch that does not rub off
    • Unlike pseudomembranous candidiasis
    • Used when the etiology of the white patch is unknown; once a cause is identified, the term leukoplakia is no longer used.

Management

  • Biopsy is mandatory

Proliferative Verrucous Leukoplakia

Clinical Presentation and Etiology

  • Recurrent and warty in appearance
  • May be associated with HPV 16 and 18
    • These are high-risk strains also associated with cervical cancer.

Prognosis

  • High risk of malignant transformation to Squamous Cell Carcinoma (SCC) or verrucous carcinoma

Erythroplakia

Clinical Characteristics3

  • Clinical description, not a diagnosis
  • Red patch
  • Higher risk of malignancy than leukoplakia
    • Erythroleukoplakia: A mixed red and white lesion that carries an even higher risk of malignancy.

Management

  • Biopsy is mandatory
    • Required to analyze the histology under a microscope and determine the cause.

Actinic Cheilitis

Etiology and Definition4

  • Actinic refers to solar exposure
  • Condition is due to sun damage (specifically UVB radiation)
    • Inflammation of the lip caused by sun damage
    • UVB rays ("B is for bad").

Smokeless Tobacco Associated Lesion

Clinical Presentation5

  • White mucosal change occurring in the vestibule
    • Wrinkly, whitish appearance
    • Location is most common in the vestibule because this is where chewing tobacco is typically held.
  • Caused by the direct effects of smokeless tobacco and its additives

Footnotes

  1. Original PDF page 1: Oral Pathology - 05 - Mucosal Premalignant Lesions, p.1 ↩

  2. Original PDF page 2: Oral Pathology - 05 - Mucosal Premalignant Lesions, p.2 ↩

  3. Original PDF page 3: Oral Pathology - 05 - Mucosal Premalignant Lesions, p.3 ↩

  4. Original PDF page 6: Oral Pathology - 05 - Mucosal Premalignant Lesions, p.6 ↩

  5. Original PDF page 7: Oral Pathology - 05 - Mucosal Premalignant Lesions, p.7 ↩

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