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    Premalignant Lesions and Conditions New

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    Premalignant Lesions and Conditions New

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    PREMALIGNANT LESIONS AND CONDITIONS NEW (1) (1)

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    of 25

    RED

    LESIONS
    Lesions of the oral mucosa that appear
    clinically red results from
    ⚫ Atrophic epithelium
    ⚫ Reduction in the number of epithelial cells
    ⚫ Increased vascularization
    ⚫ Blood vessels enlargement
    ⚫ Presence of blood in the tissue
    ⚫ Increased hemoconcentration
    CLASSIFICATION
    1. INTRAVASCULAR LESIONS
    ⚫ CONGENITAL VASCULAR ANOMALIES
    1. Congenital hemangiomas and congenital vascular malformation.
    2. Encephalotrigeminal angiomatosis (Sturge-weber syndrome).
    3. Hereditary hemorrhagic telangiectasia (Rendu-Osler weber
    syndrome).
    ⚫ REACTIVE LESIONS
    1. Pyogenic granuloma
    2. Peripheral giant cell granuloma
    3. Scarlet fever
    ⚫ NEOPLASMS
    1. Erythroplakia
    2. Kaposi’s sarcoma
    ⚫ METABOLIC-ENDOCRINE CONDITIONS
    1. Vitamin B deficiencies
    2. Pernicious anemia
    3. Iron deficiency anemia
    4. Burning mouth syndrome
    ⚫ IMMUNOLOGIC ABNORMALITIES
    1. Plasma cell gingivitis
    2. Drug reactions and contact allergies

    2. EXTRAVASULAR LESIONS
    Petechiae and Ecchymoses
    ERYTHROPLAKIA
    WHO defines Erythroplakia as
    “Any lesion of oral mucosa that presents
    as a bright red velvety patch, which cannot
    be characterized clinically or pathologically
    as any other recognizable condition.”
    ETIOLOGY
    ⚫ Idiopathic
    ⚫ Alcohol and smoking
    ⚫ Candida infection
    ⚫ Chewing tobacco

    CLINICAL FEATURES
    ⚫ Common in male.
    ⚫ Occurs in 6 th and 7 th decade of life.
    ⚫ Common sites buccal mucosa, soft palate, ventral surface of
    tongue, floor of the mouth.
    ⚫ Appear as a bright red velvety patch that is well defined from the
    surrounding mucosa .
    ⚫ Usually asymptomatic.
    ⚫ May be smooth or nodular.
    ⚫ Highest risk of malignant transformation.
    HISTOPATHOLOGY
    ⚫ Important feature of this lesion is cellular atypia.
    ⚫ Associated with atrophy of epithelium.
    ⚫ A significant number of these lesions display epithelial
    atypia throughout all cellular layers known as
    carcinoma in situ.
    ⚫ Epithelium is atrophic with inflammation, so that lesion
    appear red clinically.
    ⚫ Biospsy is necessary.
    MANAGEMENT
    1. Treatment involves biopsy of the lesion to identify
    extent of dysplasia.
    2. Complete excision of the lesion is sometimes
    advised depending on the histopathology found in the
    biopsy.
    3. Even in these cases, recurrence of the erythroplakia
    is common and, thus, long-term monitoring is needed.
    4. Because erythroplakia can develop into cancer,
    people with this condition should avoid known risk
    factors, such as using tobacco and drinking alcohol.
    DISTINGUISH BETWEEN WHITE
    LESIONS AND RED LESIONS
    WHITE LESIONS RED LESIONS
    Lesions appear as white coloured Lesions appear as red coloured
    patches in the Oral cavity. patches in the oral cavity.

    Less vascularity More vascularity

    Necrosis of epithelium Atrophy of epithelium

    More keratinized tissues Less keratinized tissues

    Very low risk of malignant Very high risk of malignant


    transformation. transformation.
    PREMALIGNANT
    LESIONS AND
    CONDITIONS
    PRECANCEROUS OR
    PREMALIGNANT LESIONS
    A morphologically altered tissue in which
    oral cancer is more likely to occur than its
    apparently normal counterpart.

    EXAMPLES:
    Include Leukoplakia, Erythroplakia , and the
    Palatal lesions of reverse smoker,
    Barret’s esophagus, Adenomatous polyps of
    stomach or colon.
    PRECANCEROUS OR
    PREMALIGNANT CONDITIONS
    A generalized state associated with
    significantly increased risk of cancer.

    EXAMPLES:
    Include Submucous fibrosis, Lichen planus,
    Epidermolysis bullosa, and Discoid lupus
    erythematous.
    CLASSIFICATION OF PREMALIGNANT LESIONS
    AND CONDITIONS

    PREMALIGNANT LESIONS
    ⚫ LEUKOPLAKIA
    ⚫ ERYTHROPLAKIA
    ⚫ LEUKOKERATOSIS NICOTINA PALATINAE
    ⚫ CANDIDIASIS
    ⚫ CARCINOMA IN SITU
    PREMALIGNANT CONDITIONS
    ⚫ ORAL SUBMUCOUS FIBROSIS
    ⚫ ORAL LICHEN PLANUS
    ⚫ ACTINIC KERATOSIS
    ⚫ DISCOID LUPUS ERYTHEMATOSUS
    ⚫ SIDEROPENIC DYSPHAGIA
    DISTINGUISH BETWEEN PREMALIGNANT
    LESIONS AND CONDITONS

    PREMALIGNANT LESIONS PREMALIGNANT CONDITIONS


    Also known as PRECANCEROUS Also known as PRECANCEROUS
    LESIONS. CONDITIONS.
    A morphologically altered tissue in A generalized state associated with
    which oral cancer is more likely to significantly increased risk of cancer .
    occur than its apparently normal
    counterpart.

    FOR EXAMPLE FOR EXAMPLE


    Leukoplakia, Erythroplakia , Palatal Sub mucous fibrosis, Lichen planus,
    lesions of reverse smokers Epidermolysis bullosa, Discoid lupus
    erythematous
    Those lesions in which carcinoma Associated with a risk of carcinoma
    may develop. at some site within the mouth not
    necessarily marked by a pre­
    existing lesion.
    PREMALIGNANT
    LESIONS
    LEUKOPLAKIA

    Already discussed in lecture of


    “WHITE LESIONS”
    ERYTHROPLAKIA

    Already discussed in lecture of


    “RED LESIONS”
    LEUKOKERATOSIS NICOTINA
    PALATINAE

    Already discussed in lecture of


    “WHITE LESIONS”
    CANDIDIASIS

    Already discussed in lecture of


    “WHITE LESIONS”
    CARCINOMA IN SITU
    ⚫ In situ (literal meanings) --- in the original place

    A group of abnormal cells that remain in the place where


    they first formed and does not spread. These abnormal
    cells may become cancer and spread into nearby
    abnormal tissue.

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