Dent 355 Rima Huda Lab Keratosis
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Transcript of Dent 355 Rima Huda Lab Keratosis
Dent 355Dent 355Laboratory Session Laboratory Session
Keratoses and Related Keratoses and Related Disorders of Oral MucosaDisorders of Oral Mucosa
Dr. Rima SafadiDr. Rima SafadiModified from Dr. Huda Modified from Dr. Huda
HammadHammad
Normal Oral MucosaNormal Oral Mucosa
Color of normal Color of normal oral mucosaoral mucosa
Normal Oral MucosaNormal Oral Mucosa
Color of normal Color of normal oral mucosa: oral mucosa: vascularity, vascularity, melanin, epithelial melanin, epithelial thickness, thickness, keratinization.keratinization.
Normal Oral MucosaNormal Oral MucosaNon-keratinized partsNon-keratinized parts
Normal Oral MucosaNormal Oral MucosaNon-keratinized partsNon-keratinized parts
Normal Oral MucosaNormal Oral MucosaKKeratinized Partseratinized Parts
White PatchesWhite Patches
DebrisHyperkeratosis
Definition of Histopathological Definition of Histopathological TermsTerms
Pyknotic nuclei: parakeratosis Granular cell layer
orthokeratin
Definition of Histopathological Definition of Histopathological TermsTerms
Acanthosis
Atrophy
Cellular atypia, Cellular atypia, Epithelial dysplasia.Epithelial dysplasia.
Dysplasia
Hereditary Conditions Hereditary Conditions (Genodermatoses): Oral Epithelial (Genodermatoses): Oral Epithelial Nevus (White Sponge Nevus)Nevus (White Sponge Nevus)
Hereditary Conditions Hereditary Conditions (Genodermatoses): Oral Epithelial (Genodermatoses): Oral Epithelial
Nevus (White Sponge Nevus)Nevus (White Sponge Nevus)
-Intracellular edema of prickle and cell layers.Intracellular edema of prickle and cell layers.Hyperkeratosis
Hereditary Conditions Hereditary Conditions (Genodermatoses): Leukoedema(Genodermatoses): Leukoedema
Hereditary Conditions:Hereditary Conditions:LeukoedemaLeukoedema
Intracellular edemaAnd glycogenCells appear vaculated
Thick epithelium with broad rete ridges
Traumatic Keratoses: Traumatic Keratoses: Mechanical Trauma-Frictional Mechanical Trauma-Frictional
KeratosisKeratosis
Trauma-Frictional KeratosisTrauma-Frictional KeratosisHabitual cheek bitingHabitual cheek biting
Traumatic Keratoses: Traumatic Keratoses: Mechanical Trauma-Frictional Mechanical Trauma-Frictional
KeratosisKeratosis Histopathology: Histopathology: - Hyperkeratosis +/- Hyperkeratosis +/-
acanthosis.acanthosis.- There is There is nono dysplasia. dysplasia.
Traumatic Keratoses: Traumatic Keratoses: ChemicalChemical
Aspirin burn.Aspirin burn.
Traumatic Keratoses: Traumatic Keratoses: ChemicalChemical
Snuff dipper’s lesion.Snuff dipper’s lesion.
Similar to chronic friction
Traumatic Keratoses: Thermal Traumatic Keratoses: Thermal Nicotinic Stomatitis Nicotinic Stomatitis
Dilated duct of minor salivary gland
LeukoplakiaLeukoplakia
Homogenous LeukoplakiaHomogenous Leukoplakia
HomogeneousHomogeneous- flat, uniform, - flat, uniform,
predominantly white predominantly white plaquesplaques
- may show shallow - may show shallow cracks/fissurescracks/fissures
Leukoplakia: Clinical Leukoplakia: Clinical FeaturesFeatures
Speckeled
Speckeled
ErythroplakiaErythroplakia
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial DysplasiaDysplasia
2 features are highly 2 features are highly suggestive of smoking as suggestive of smoking as an etiological factor:an etiological factor:
1. presence of chevron peaks 1. presence of chevron peaks in keratin.in keratin.
2. increased melanin 2. increased melanin production in basal production in basal keratinocytes and leakage keratinocytes and leakage of melanin into the of melanin into the underlying connective underlying connective tissue (melanin tissue (melanin incontinence).incontinence).
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial DysplasiaDysplasia
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial DysplasiaDysplasia
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial DysplasiaDysplasia
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
1. Increased and abnormal mitoses.1. Increased and abnormal mitoses.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
2. Basal cell hyperplasia.2. Basal cell hyperplasia.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
3. Drop-shaped rete ridges.3. Drop-shaped rete ridges.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
4. Disturbed polarity of basal cells or loss of 4. Disturbed polarity of basal cells or loss of cellular orientation.cellular orientation.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
5. Increase in nuclear/ cytoplasmic ratio.5. Increase in nuclear/ cytoplasmic ratio.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
6. Nuclear hyperchromatism.6. Nuclear hyperchromatism.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia7. Prominent and enlarged nucleoli.7. Prominent and enlarged nucleoli.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia8. Irregular epithelial stratification or 8. Irregular epithelial stratification or
disturbed maturation.disturbed maturation.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
9. Nuclear and cellular pleomorphism.9. Nuclear and cellular pleomorphism.
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
10. Abnormal keratinization (dyskeratosis).10. Abnormal keratinization (dyskeratosis).
Leukoplakia: Pathology, Epithelial Leukoplakia: Pathology, Epithelial Dysplasia- Features of Epithelial Dysplasia- Features of Epithelial
DysplasiaDysplasia
11. Loss or reduction of intercellular 11. Loss or reduction of intercellular adhesion.adhesion.
Regezi
Lichen Planus: Clinical FeaturesLichen Planus: Clinical Features
Skin lesions:Skin lesions:
Lichen Planus: Clinical FeaturesLichen Planus: Clinical Features
Skin Lesions:Skin Lesions:
Lichen Planus: Clinical FeaturesLichen Planus: Clinical Features
Skin and Nail Skin and Nail Lesions:Lesions:
Lichen Planus: Clinical FeaturesLichen Planus: Clinical Features
Oral Lesions:Oral Lesions:
Reticular pattern
Lichen Planus: Clinical FeaturesLichen Planus: Clinical Features
Oral Lesions:Oral Lesions:
Non-erosive types:Non-erosive types:
- reticular or annular, - reticular or annular, papular, plaque-papular, plaque-like.like.
Lichen Planus: Clinical FeaturesLichen Planus: Clinical Features
Oral Lesions:Oral Lesions:
Erosive/atrophic typesErosive/atrophic types
Lichen Planus: Clinical FeaturesLichen Planus: Clinical Features
Oral Lesions:Oral Lesions:
Lichen planus involving the Lichen planus involving the gingiva often presents as a gingiva often presents as a desquamative gingivitis.desquamative gingivitis.
Lichen Planus: PathologyLichen Planus: Pathology
Histopathologic Features:Histopathologic Features:
Ortho- or parakeratosis.Ortho- or parakeratosis.
Epithelial atrophy or Epithelial atrophy or acanthosis (sawtooth acanthosis (sawtooth pattern of rete ridges).pattern of rete ridges).
Dense, well-defined band Dense, well-defined band of subepithelial of subepithelial mononuclear infiltrate, mononuclear infiltrate, mainly T-cells.mainly T-cells.
Lichen Planus: PathologyLichen Planus: Pathology
Histopathologic Features:Histopathologic Features:
Lichen Planus: PathologyLichen Planus: Pathology
Histopathologic Features:Histopathologic Features:
Liquefactive Liquefactive degeneration of basal degeneration of basal cell layer associated cell layer associated with edema and with edema and lymphocytic infiltration.lymphocytic infiltration.
Civatte bodies: hyaline Civatte bodies: hyaline shrunken bodies shrunken bodies representing apoptotic representing apoptotic cells.cells.
Lichen Planus: PathologyLichen Planus: Pathology
Histopathologic Histopathologic Features:Features:
Basal cell Basal cell degeneration may degeneration may result in subepithelial result in subepithelial bullae formation and bullae formation and ulceration.ulceration.
Lupus Erythematosus: Clinical Lupus Erythematosus: Clinical FeaturesFeatures
Chronic Discoid Chronic Discoid Lupus Lupus Erythematosus Erythematosus (DLE):(DLE):
Lupus Erythematosus: Clinical Lupus Erythematosus: Clinical FeaturesFeatures
Chronic Discoid Lupus Chronic Discoid Lupus Erythematosus (DLE): Oral Erythematosus (DLE): Oral Lesions Lesions
Lupus erythematosus Lupus erythematosus histopathologyhistopathology
Deep perivascular Lymphocytic infiltrate
Lupus Erythematosus: Histopathologic Lupus Erythematosus: Histopathologic FeaturesFeatures
Subepithelial and Subepithelial and deep perivascular deep perivascular lymphocytic infiltrates.lymphocytic infiltrates.
Liquefactive Liquefactive degenerartion of basal degenerartion of basal cells.cells.