Red Lesions of the oral cavity part#2.pptx

Red lesion of the oral cavity part 2

1. Dr. Hidayah Elyas Lecture 2 :- Red Diseases of Oral Cavity Dentistry program Oral Medicine

2. Reactive lesions Caused by Pyogenic Granuloma Peripheral Giant Cell Granuloma

3. Pyogenic granuloma Common tumor like growth ▪ Irritation or trauma ▪ Sessile or pedunculated ▪ Pink to red in color ▪ Develops in pregnant women in 1st trimester and increases through 7th month ▪ Gingiva common ▪ Treatment Conservative surgical excision

4. Peripheral giant cell granuloma Reactive due to local irritation GINGIVA or edentulous alveolar ridge Red or reddish-blue nodular mass which is usually < 2 cm,similar to Pyogenic Granuloma. Treatment •Local surgical excision down to the underlying bone •Scaling of the adjacent teeth of any source of irritation •Rarely, lesions similar to this are seen in Hyperparathyroidism (are mostly intraosseous )

5. Erosive Lichen Planus Usually symptomatic. Atrophic areas with central ulceration of varying degree ▪ Periphery of the atrophic regions is usually bordered by fine ,white radiating striae Pain, burning sensation, bleeding, desquamative gingivitis ▪ Pseudo membrane covered ulcerations with keratosis and erythema

6. Erosive Lichen Planus Treatment Topical steroids ( Hydrocortisone,Beclamethasone , Clobetasol ( Temovate ), Fluocinonide ) . Systemic steroids can be used ( Prednisolone ). Cautiously used due to side effects & should be slowly tapered. Steroid sparing drugs azathioprine

7. Lesions causing atrophy Few of the lesions which can cause oral mucosal atrophy are as follows: ▪ Erythroplakia ▪ Erythema Migrans ▪Lichen Planus ▪ Desquamative Gingivitis ▪Nutritional Deficiencies

8. Erythroplakia Bright red, velvety plaque that cannot be characterised clinically or pathologically as being due to any other condition Malignant transformation is found to be 18- 50%. This may be due to:- Severe epithelial dysplasia Epithelial atrophy Lack of keratin with location in floor of the mouth.

9. Erythroplakia Treatment : Cause is removed Careful watching , and frequent follow-up or surgical removal Or cryosurgery and laser surgery

10. Erythema migrans (geographic tongue) Etiology not known. Maybe stress frequent remission and recurrence. Treatment No specific treatment vitamins heavy dose

11. Atrophic Lichen Planus Smooth, poorly defined erythematus areas with or without peripheral striae or ➢Usually associated with Desquamative gingivitis ➢Pain and burning sensation ➢When this type of LP is present in the buccal mucosa or in the palate , striae are frequently seen in the periphery

12. Atrophic Lichen Planus Treatment Topical steroids ( Hydrocortisone,Beclamethasone , Clobetasol ( Temovate ), Fluocinonide ) In case of generalized or mucocutaneous lesions systemic steroids can be used ( Prednisolone ). Cautiously used due to side effects & should be slowly tapered. Steroid sparing drugs azathioprine

13. Desquamative Gingivitis Desquamative gingivitis (DG) is an erythematous (red), desquamatous (shedding) and ulcerated appearance of the gums. It is a descriptive term and can be caused by several different disorder • Treatment •Improving oral hygiene • Minimising irritation of the lesions •Specific therapies for the underlying disease (where available) •Local or systemic immunosuppressive or dapsone therapy

14. Bleeding disorders Pinpoint lesions ( Petechiae – usually 3mm in dia ) Purpura (3mm – 1cm in dia ) Diffuse Bruising ( Ecchymoses – larger than 1cm in dia ) are seen mainly at the site of Trauma Such SIGNS could be PIVOTAL in potentially saving a patient’s life They will NOT Blanch

15. Vascular anomalies Dilated lingual veins Haemangiomas Telangiectasias

16. TELANGIECTASIA HEMANGIOMA Also known as “Dilated Capillaries” Usually occur after Irradiation of the mouth & in certain Systemic Disorders such as Systemic Sclerosis & Hereditary Hemorrhagic Telangiectasia (Osler Weber Rente Syndrome)…… Benign Tumor Like Lesions which can be present in any part of oral cavity specially Tongue Reddish or Purple in color Can be associated with STURGE WEBER SYNDROME(is a neurological disorder marked by a distinctive port-wine stain on the forehead, scalp, or around the eye. This stain is a birthmark caused by an overabundance of capillaries near the surface of the skin)……. Can be confused with Arteriovenous Malformations

17. Hemangioma

18. Investigations & Treatment for Vascular Anomalies For all three vascular anomalies, Diascopy , Angiography, computed tomography (CT), and magnetic resonance imaging (MRI) are useful. ▪ Treatment modalities (alone or in combination) include super selective intra-arterial embolization (SIAE), sclerotherapy , radiotherapy, or surgical excision/ resection using electrocoagulation , cryosurgery, or laser surgery

19. Neoplasms ▪Peripheral Giant Cell Tumors ▪ Angiosarcoma’s such as Kaposi’s Sarcoma ▪ Squamous Cell Carcinoma ▪Basal Cell Carcinoma ▪Malignant Melanoma in case of ulceration at the site of lesion

20. Thank you