Oral Cavity

Congenital development disorders

• Fordyce’s spots: Numerous yellowish white bodies found on the upper lip as a result of ectopic sebaceous glands.
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• Lymphoepithelial cyst: Can occur anywhere (i.e.: oral, cervical etc). It’s a cyst whose internal lining is keratinised squamous epithelium, and its outside is lined by a capsule. Within this cyst are multi-lymphoid follicles which contain lymphocytes.
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• Peutz-Jeghers syndrome: Intestines have hamartomatous polyps, and this is associated with brown black lesions around lips.
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• Macroglossia: big tongue. You get this if you have three copies of chromosome 21, instead of the normal two.
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• Microglossia: small tongue.
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• Cleft upper lip (hare lip) +- cleft palate: Visit this website for photo. http://hcd2.bupa.co.uk/fact_sheets/html/cleft_lip.html . Cleft palate affects roof of the mouth.
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• Ankyloglossia: The fraenulum underneath your tongue attaches the tongue to the base of the oral cavity, thus limiting its movement. If you have a very short fraenulum or it consolidates, it limits tongue movement  tongue tie.
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• Branchial cleft cysts: There are lumps on one side of the neck, which contains fluid. Abnormal development of neck structures.
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• Xeroderma Pigmentosa: Inherently, the body can repair DNA damaged from UV rays. In this condition, which is inherited, the body is not able to do this. The DNA of skin cells are damaged permanently. It is autosomal recessive (i.e.: need two recessive genes for trait to be seen).

Oral inflammations

• Lichen planus: inflammatory condition of the skin. No cause indentified, but allergic reactions that look similar have been identified after use of drugs. It is not infectious or cancerous.
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• Aphthous ulceration: Round/Oval ulcers on mucous membranes that are not firmly bound to bone. Common areas are: inside of lips, insider of oral cavity, genital areas etc.
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• Oral candidiasis (aka: thrush, moniliasis, candidiasis): Predominantly caused by candida albicans. Its is a commensal in 30-40% of humans, and commonly affects the oral cavity. Clinically, you see creamy blotches insider oral cavity or tongue. It is an opportunistic infection, which can occur if certain predisposing factors exist: 1) antibiotic treatment, 2) diabetes mellitus, 3) immunocompromised, 4) debilitation.

Other oral conditions

• Crohn’s disease: This is an inflammatory bowel condition. Ulcerative colitis is the other variety. Crohn’s can affect any part of the GIT system. See other lectures for more information.
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• Dilantin therapy: Fibrous hyperplasia of the gingiva can occur with this therapy.
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• Amyloidosis of tongue: Amyloidosis is basically deposition of proteinatious material called amyloid in the extracellular tissue of organs. In this case, these deposits occur in the tongue.

Leukoplakia & Erythroplasia (erythroplakia)

Leukoplakia: This affects the oral cavity. Patient notice a white patch that is at least 5cm in diameter, and it cannot be rubbed off and not be diagnosed as anything else. It is potentially (i.e.: different types of leukoplakia have different rates of progressiont to cancer) a pre-cancerous lesion.

Erythroplasia: This is basically a red patch/plaque that cannot be categorised as any other disease process. This is also a premalignant lesion.

Category: Pathology Notes