5. Wide spectrum of pink colors varying from a
dark pink(reddish) to a very pale pink(almost
white)
1. Lining mucosa --- Reddish pink
2. Masticatory mucosa--Light pink
Protective layer of keratin
Dense sub epithelial connective tissue
6. Deep dusky red in color
contrast to light red
color of surrounding
tissue.
Painless red macular
bands may present
Richer blood supply
Individual normal
variation
12. Vascular dilations from
a. Inflammation (Erythema)
b. Congenital defects(e.g. hemangioma)
Extravasations of blood (e.g. trauma
hemostatic disease or both)
Atrophy or erosion of mucosa
Marked increase in hemoglobin
concentration of circulating blood
13. Inflammation
(Erythema)
Mechanical trauma
Thermal trauma
Chemical trauma
Infections
Ulcer with inflamed rim
Congenital defects(e.g.
hemangioma)
14. Erythematous macule
Erosion
The purpuric macule
Granulomatous stage of inflammatory
hyperplasia
15. Etiology --Produce by low grade, usually
chronic physical insult
Sharp margins of teeth & restorations
Ill-fitting prosthesis
Self inflected trauma
Habits
16. Clinical feature (c/f)
Erythematous macule are
on
Anterior & lateral border of
tongue
Cheek mucosa
Lip mucosa
Margins may or may not be
sharply defined
17. Mild tenderness
Digital pressure may
cause blanching
Regress quickly
after removal of
cause
20. Caused due to blunt trauma which is sufficient
force to cause the extravasations of blood.
Soon after the traumatic damage, lesion is red
afterwards converts into blue color.
Borders are poorly demarcated
Blanching on pressure does not usually occur
May also have secondary inflammatory
component.
22. The purpuric macule
due to oral
sexual practices.
Reddish
Elliptical
Purpuric macule
Occurring on palatal mucosa
near the junction of the hard & soft palate.
Disappear within 2 to 3 days
Judicial history with confidential setting revel
the true identity.
35. Caustic drugs or hot foods or beverages
Depends on duration & intensity of stimuli
Stimuli may produce coagulative necrosis
of superficial tissues that appears white
After scraping off that white layer it may
produce clinically appreciable red lesion
36. Ulceration & properly stripping off mucosa
Tender to painful
May blanch on pressure
Size & shape varies depend on stimuli.
40. Conventional smokers
Is seen primarily on the palate of pipe
smokers.
Also seen in bidi smoker
Does not having premalignant nature
It develops in response to heat rather than
tobacco.
41. Appears red in initial stage
In later keratotic
stage minor salivary
duct orifices
appear red
Men , 4-5 decade
44. Erythroplakia
• Commonly seen on buccal mucosa , floor of mouth,
tongue
Definition –
Persistent velvety red patch that can not be
identified as any other specific red lesion such as
inflammatory Erythema or those produce by blood
vessel anomalies or infection.
45. It appear red because
Absences of surface keratin layer
Connective tissue papillae, containing
enlarge capillaries, project close to the
surface.
46. C/F-
• Velvety red or
granular red macules.
• Varies greatly in size
• Borders may be
well defined
• Painless
• Drying of the mucosa will intensify the red colour
48. The lesion may have an irregular, red
granular surface interspersed with white
or yellow foci, which may be described as
granular erythroplakia.
There may be numerous, small irregular
foci of leukoplakia dispersed in the
erythroplakic patch, and this has been
called speckled leukoplakia.
49. Oral erythroplakia is soft to palpation and
does not become indurated or hard until an
invasive carcinoma develops.
50. Histopathologically
erythroplakia almost
always show dysplasia,
carcinoma in situ or
invasive squamous cell
carcinoma.
Epithelium is frequently
atrophic with lack of
keratin production.
The connective tissue
demonstrates chronic
inflammation.
51. If the lesion persist for more than 21 days
after all local trauma & infections foci have
been eliminated, biopsy is mandatory.
53. Malignant epithelial neoplasm exhibiting
Squamous differentiation as characterized
by formation of keratin & / or presence of
intercellular bridges
(pinborg JJ 1997)
54. Annually, nearly 30,000 new cases of oral
and oropharyngeal cancer are expected to
occur in men and women in the United
Sates.
The ratio of cases in men and women is
now about 2 to 1.
55. Tobacco,
Typically mixed with areca (betel) nut,
Slaked lime,
All forms of tobacco smoking
Reverse smoking
Alcohol
Poor nutritional status
HPV 16 & 18 has some role in the
development of OSCC.
Ultraviolet (UV) light
57. The first is loss of cell cycle control through
increased proliferation and reduced
apoptosis.
The second stage is increased tumor cell
motility, leading to invasion and
metastasis.
58. Carcinoma of the Lips:
Carcinomas of the lower lip are far more
common than upper lip lesions.
Pipe smoking, uv light exposure.
The growth rate is slower for lower lip
Favorable prognosis
Account for 25% to 30% of all oral cancers
59. Lesions arise on the vermilion surface
Appear as a chronic non healing ulcer
(Exophytic ,verrucous type may present)
Deep invasion -- later in the course of the
disease.
Metastasis to local submental or
Submandibular lymph nodes is uncommon
60.
61. One of the most common intraoral
malignancy.
Predilection for men (6-8th decade)
However, lesions may uncommonly be
found in the very young.
62. Exhibit a particularly aggressive behavior.
Lingual carcinoma is typically
asymptomatic.
As deep invasion occurs, pain or dysphagia
may be a prominent patient complaint.
63. Appear in one of four ways:
indurated, nonhealing ulcer,
a red lesion,
a white lesion,
a red-and-white lesion.
64. The neoplasm may occasionally have a
prominent exophytic, as well as
endophytic, growth pattern
65. The most common location of cancer of the
tongue is the posterior-lateral border.
Specific reason is due to chronic irritation
because of tooth
Approximately 1/4th of tongue cancers
occur in the posterior one third or base of
the tongue.
66. Metastases from tongue cancer are relatively
common.
The first nodes to become involved are the
submandibular lymph node.
Uncommonly, distant metastatic deposits may
be seen in the lung or the liver.
67. Second most common intraoral location of
squamous cell carcinomas.
Predominantly in older men,
68. Painless, nonhealing, indurated ulcer.
It may also appear as a white or red patch.
May widely infiltrate the soft tissues of the floor
of the mouth,
Decreased mobility of the tongue.
Metastasis to Submandibular lymph nodes is
common
71. It is slow growing
Usually well differentiated,
Rarely metastasizes,
Has a favorable prognosis
72.
73. Palatal squamous cell carcinomas
generally present as asymptomatic red
or white plaques or as ulcerated and
keratotic masses
74. 1. Well differentiated:
It consists of sheets and nests of cells of
squamous epithelium.
Cells are large and show distinct cell
membrane but intercellular bridges or
tonofibrils are not seen.
Pleomorphic nuclei and becomes
hyperchromatic.
75. Mitotic figures are seen but not numerous.
Individual cell keratinization and
formation of numerous keratin pearl.
Group of cells invades underlying
connective tissue.
76.
77. Shape of cells and their arrangement may
be altered.
The growth rate of individual cells is more
rapid and this is reflected in the greater
numbers of mitotic figures.
Keratin pearl formation may or may not be
seen.
78.
79.
80. More pleomorphic cells.
Loss of keratinization and keratin pearl.
Loss of individual cell differentiation.
Increase mitotic figures.
83. Coxsackie virus A4 -cause a majority of cases
of Herpangina,
Types A1 to A10, A16 to A22
Herpangina may be seen more than once in
the same patient.
Herpangina frequently occurs in epidemics
The majority of cases affect young children
adolescents.
84. Clinical Manifestations.
After a 2- to 10-day incubation period,
The infection begins with generalized
symptoms of fever, chills, and anorexia.
85. The fever and other symptoms are
generally milder than those experienced
with primary HSV infection.
The patient complains of sore throat,
dysphagia, and occasionally sore mouth.
86. Lesions start as punctate macules, which
quickly evolve into papules and vesicles
involving the posterior pharynx, tonsils,
faucial pillars, and soft palate.
Lesions are found less frequently on the
buccal mucosa, tongue, and hard palate.
87. Within 24 to 48 hours, the vesicles rupture,
forming small 1 to 2 mm ulcers.
The disease is usually mild and heals
without treatment in 1 week.
88. Definition Infectious mononucleosis is an acute,
self-limited infectious disease that primarily affects
children.
Etiology
Epstein–Barr virus transmitted through saliva
transfer,
Cytomegalovirus (CMV)
CMV is the major cause of non-Epstein-Barr virus
infectious mononucleosis in the general
population.
89. The oral manifestations are early and
common, and consist of
palatal petechiae,
uvular edema,
tonsillar exudate,
gingivitis,
rarely ulcers
90. Generalized
lymphadenopathy,
hepatosplenomegaly,
maculopapular skin rash,
sore throat are common.
Prodromal symptoms such as anorexia,
malaise, headache, fatigue, and later fever
occur before the clinical manifestations.
93. It is the infection with yeast like fungus Candida albicans
Earlier termed moniliasis
Types
ACUTE CHRONIC
Psuedomembranous Hyperplastic
Atrophic Mucocutaneous
Atrophic
Candidiasis
94. clinical type Appearance
Erythematous Red
Atrophic Red
Hyperplastic White, red raised
Mixed Red/ white keratotic / white necrotic
Mucocutaneous Lip/ angles
Psuedomembranous White lesion
99. Due to denture cuts off the underlying
mucosa from the protective action of
saliva.
The erythema is sharply limited to the area
of mucosa occluded by a well-fitting upper
denture or even an orthodontic plate.
101. It is red colored unraised area usually
present on buccal mucosa.
It is usually capillary type,
Also occur as port wine stain on skin.
102. History of long duration
It is non tender
Even no inflammatory component
Absence of recurrent traumatic episode
103. References-
Text book of oral and maxillofacial
pathology- Neville
Differential diagnosis of oral lesions by-
Wood and Goaz, Fifth Edition
Shafer’s textbook of oral pathology 6th
edition .
Textbook of oral medicine Burkait 10th
edition .