ACROCHORDON - skin tag
- Appear stalk-like or pedunculated
- Small , slender, flesh colored tags of skin blending with surrounding tissue
- Benign and pose no problem for client
- Check for future changes
COMEDONES - blackheads
Dilated hair follicles filled with keratin, bacteria and sebum�blackened mass of epithelial debris
Milia
*** Small subepidermal keratinous cysts (also called epidermal inclusion cysts) which develop when tiny skin flakes become trapped in small pockets near the surface of the skin
- Primary milia are formed directly from entrapped keratin and are usually fou
Solar Lentigo
- Benign macules from sun exposure
- Usually larger than freckles and fade when sun exposure is diminished
- Sometimes called liver or age spots
- Vary in number depending on cumulative sun exposure
*irregular shape & vary in color
Melasma
A skin condition presenting as brown patches on the face of adults; usually bilateral. The most common sites of involvement are the cheeks, bridge of nose, forehead, and upper lip.
Also known as chloasma or the mask of pregnancy when present in pregnant w
RHINOPHYMA
- Located on nose
- Marked overgrowth (hyperplasia) of sebaceous glands
- Cause unknown, it may be a severe form of a skin disease called rosacea
- Enlarged and appearing swollen with increased fibrosis connective tissue and vascularity (rosacea)
- Predom
XANTHELASMA
- Most commonly located on or around eyelids
- More common in females
- Pale yellow-orange raised area at the corner of the eye
Predominantly lipid material ; 50% affected will have high triglycerides or high cholesterol ***
Vitiligo
- Characterized by lighter appearance of the tissue due to loss of pigment and destruction of melanocytes
- Affects skin and mucous membranes
- Family history and clients associated with disease such as pernicious anemia hyperthyroidism, autoimmune disord
Preauricular Sinus
Preauricular sinuses are common congenital malformations
Result of incomplete fusion of 6 hillocks(elevations) from first and second brachial arches
Preauricular cysts connect to the outside with a sinus tract that opens into a pit, just anterior to the r
Preauricular Sinus Treatment
Once a patient acquires an infection of the sinus, a systemic antibiotic is required. If an abscess is present, it must be incised and drained
Once an infection occurs, the likelihood of recurrent acute exacerbations is high, and the sinus tract should be
Gingival Mandibular Ridges
- Located on molar attached gingiva (usually bilateral) , they appear as small, white to pink linear slightly raised lesions
- Composed of dense collagen
- Are normal structures which may be mistaken for disease
- More common in middle aged males
Gingival Fibrous Nodules
- Exophytic small asymptomatic pink fibrous nodules with sessile base.
- Composed of dense collagen
- They may be single or multiple and are located on mucogingival zone of the mandibular anterior gingiva.
- Are a variant of normal that may be mistaken fo
Lip Licking
Lip licking-eczematous condition of the skin around the lips presents as contact dermatitis from the constant wetting and irritation of the saliva
- Only skin accessible to tongue
- Red, scaling, crusted
- Predominantly in children
Lip Fissure
- Children may develop painful persistent fissure of the lip
- Result of wind, sun, mouth breathing and lip licking
- Topical steroid may be required
Mandibular Tori
- Exophytic growths of normal dense bone, genetic
6-12 % of adult population
- Usually bilateral, often lobulated and can appear fused together
- Found on lingual aspect of mandible in the premolar and molar region
- No treatment unless they interfere wit
Palatal Torus
- An exophytic growth of normal compact bone located in the midline of hard palate
- Genetic, occurring in 10% of population: mostly in women
- Asymptomatic unless traumatized
- Vary in shape and size, may be flat or lobulated
- No treatment unless interf
Exotosis
- Asymptomatic , bony outgrowths of the outer cortex of the mandible and maxilla
- May occur on buccal or lingual alveolar bone as rounded bony nodules
- The surface mucosa is firm, taut and white to pale pink
- Tori and exostosis increase slowly in size
Melanin Pigmentation
- Melanin is the pigment that gives color to the skin, eyes, hair, mucosa and gingiva.
- Pigmentation occurs in varied hues depending upon racial and genetic factors and the increase in melanin production from melanocytes.
- Some patients complain about t
Retrocuspid Papillae
Found on the lingual gingiva of mandibular cuspid
- Firm, sessile nodule about 1 to 4mm in diameter and found bilaterally
- Seems to be present in most children but regresses with maturity
- No gender preference
Frenal Tag
- A redundant(extra) piece of mucosal tissue that projects from the labial frenum
- Cause is unknown however it was once thought to be a fibrous hyperplasia associated with trauma (studies inconclusive)
- Frequent developmental anomaly
- Does not represen
Linea Alba
- Elevated grayish white wavy line on the buccal mucosa
- Usually bilateral and asymptomatic
- 1 to 2 mm wide and extends anteroposteriorly along the occlusal plane
- The thickened epithelial changes consist of hyperkeratotic tissue due
to frictional acti
Leukoedema
An opalescent, milky-white or gray
surface change of the buccal mucosa
with fine lines and folds; more
prominent in smokers
- Most common in African American
adults
- Mucosal changes at 3-5 years, more noticeable at adolescence; 50% have altered mucosa at
Fordyce Granules
White or yellow granular papules on found on the buccal mucosa and vermillion border of the lip. Less frequently located labial mucosa, retromolar pad, tongue, attached gingiva and frenum
- Arise from sebaceous glands embryologically entrapped during fusi
Lingual Varicosity
- Commonly seen on clients over 60 years of age
- Is related to aging process due to venous dilatation caused by reduced elasticity of vascular wall
- May be related to leg varicosity
- Commonly appear superficial on the ventral surface of the anterior tw
Venous Varix
- Similar to lingual varicosities
- Usually less than 5mm
- Appear as deep blue, red or purple broad based elevations of mucosa
- Common in older adults
- Occurs singularly on the lip or buccal mucosa when vessel wall becomes weak from chronic sun exposur
Petechiae, Purpura and Ecchymoses
Hemorrhages in the soft tissue due to either trauma or blood dyscrasia. When caused by dyscrasia, it is because of fewer platelets and/or clotting factor problems
- Are located directly under the skin surface
- They do not blanch when pressure is applied
Petechiae
a pinpoint, non-raised, circular red spots located on skin or mucous membranes caused from a minute intradermal or submucosal hemorrhage. Size ranges from 1-2 mm
Purpura
local circumscribed purplish/brownish-red discolorations caused by bleeding into the skin or tissues
- Vary in size and severity less than 1cm.
- Is a symptom rather than disease entity. Fragile blood vessels (senile purpura-elderly), drugs that affect pl
Ecchymoses
are hemorrhagic spots in the skin or mucous membranes ; larger than purpura over 1cm.
- May be associated with Leukemia , polycythemia(increased RBC) and hemophilia(group of bleeding disorders)
Pathogenesis OF
- May arise from several sources
- Traumatic injury is the most common source
- Biting soft tissue, trauma from chewing food, coughing, sneezing, vomiting, fellatio
- Dental procedure such as saliva ejector, hand piece, xray or impression tray misplacemen
Treatment: OF
Treating underlying cause and removing sources of trauma
Prognosis: depends on cause of the lesion.
- Lesions associated with trauma subside within a week or more when offending source is removed
- Disease states : indefinite
Differential Diagnosis :
1) B
Double Lip
- Anomaly characterized by a horizontal fold of redundant(extra) mucosal tissue that is usually located on the inner aspect of the upper lip. Lower lip may occasionally be involved.
- May be congenital or acquired
- Visible when lip is tense
Fissured Tongue
- A variation of normal tongue anatomy
- Consists of a single midline, double fissured or multiple fissures of the dorsal surface
- Various patterns, lengths, and depths have been observed
- Cause is unknown but probably developmental or genetic factors;
Geographical Tongue (Benign Migratory Glossitis, Erythema Migrans)
Inflammatory condition of connective tissue (biopsy)
Cause is unknown but genetic and atopic (allergic) factors may play a role
- Associated stress and psoriasis
- Affects 2-3% of population
- Clinically it affects the dorsal and lateral borders of the to
Ectopic Geographic Tongue
- In rare instances mucosal sites other than the tongue are affected (erythema migrans)
- Most commonly found in the mandibular anterior mucobuccal fold
- May be associated with psoriasis
Hairy Tongue
Pathogenesis- An increased accumulation of keratin which elongates the filiform papillae, resulting in a white hairy appearance
- Black hairy tongue is caused by chromogenic bacteria
- Extrinsic factors may discolor the papillae such as tobacco or food
Tr
Median Rhomboid Glossitis
- Maybe associated with chronic fungal infection (Candida albicans) in conjunction with smoking or change in oral pH
- Well-demarcated, flat or slightly raised erythematous oval or rectangular area in the midline of the dorsal surface of the tongue extend
Lingual Thyroid Nodule
Thyroid gland begins development in 1st month of fetal life and is located in the foramen cecum area. In normal development it descends to the normal location in the neck.
When thyroid tissue becomes trapped in tissue that makes up the tongue a "lingual t
Lingual Thyroid Nodule Clinically
It appears as a mass in the midline of the dorsal surface of the tongue posterior to the circumvallate papillae
- Sessile base is 2-3 cm in width
- More common in females
- Hormonal since the onset is associated with pregnancy, puberty and menopause
Lingual Thyroid Nodule Treatment
- Requires evaluation of the client to determine if thyroid gland is in its normal location in neck before surgical removal
- In 50% of cases, patients with ectopic thyroid, the lingual thyroid is the only active thyroid tissue present
- Thyroid replaceme