Red And White Lesions Short Essays

Red And White Lesions

Question 1. TNM staging
Answer: TNM staging

It is the staging of malignancy which measures 3 major parameters of cancer

  • T- the size of the tumor
    • N- lymph node involvement
    • M-distant metastasis
  • T- Primary tumor
    • The tx-primary tumor cannot be assessed
    • To-No evidence of primary tumor
    • This- carcinoma in situ o Ti- Tumour size- 2 cm or less in diameter
    • T2– Tumour size- 2-4 cm in diameter
    • T3– Tumour size- more than 4 cm in diameter
    • T4– Tumour invades adjacent structures
  • N- Regional lymph node
    • Nx – Regional lymph node cannot be assessed
    • N0-No regional lymph node metastasis
    • N1– Metastasis in a single ipsilateral lymph node, 3 cm or less in dimension
    • N2– Metastasis in the single ipsilateral lymph node, more than 3 cm but less than 6 cm
    • N2a– Metastasis in the single ipsilateral lymph node, 3-6 cm in dimension
    • N2b – Metastasis in multiple ipsilateral lymph nodes, not more than 6 cm
    • N2c– Metastasis in bilateral or contralateral lymph nodes, not more than 6 cm
    • N3 – Metastasis in the lymph node, more than 6 cm in dimension
  • M- Distant metastasis
    • Mx – The presence of distant metastasis cannot be assessed
    • M0 – No distant metastasis Mi – Presence of metastasis
    • M1– Presence of metastasis

Read And Learn More: Oral Medicine Question and Answers

Question 2. Treatment of cancer
Answer: Aims Of Cancer Treatment:

  • Cure of the patient
  • Palliation
  • Preservation of function
  • Cosmetic function
  • Treatment of lymph node
  • Treatment of advanced tumors

Role Of Chemotherapy:

    • Cisplatin is the most effective drug
    • In advanced cases, chemotherapy is given before surgery or radiotherapy
    • This is called induction chemotherapy


    • Radiotherapy preserves anatomical parts and functions
    • 6500-7500 cGy units are required to eradicate cancer

Role Of Surgery:

    • It may be in the form of wide excision or wide excision with removal of the bone
    • Radical neck dissection is done in case of lymph node involvement

Question 3. Lichenoid reactions
Answer: Lichenoid reactions

It has a clinical picture similar to lichen planus


  • Disorders: lichen planus
  • Drugs:
    • Antimicrobial: tetracycline
    • Anti par asltit thlornquine
    • Antihypertensive methyl dopa
    • Anti ills gold

Lichenoid Reactions Clinical Features:

    • Lichenoid mm positive over oral mucosa
    • Lichenoid dermatitis: over the skin
    • Lichenoid gingivitis.: over gingiva

Lichenoid reactions Management: discontinuation of the drug

Question 4. Erythroplakia.


  • It is a red patch or plaque in the oral mucosa which cannot be characterized clinically or pathologically as any other condition and which has no apparent cause


  • Use of tobacco
  • Alcohol
  • Candida infection
  • Idiopathic

Erythroplakia Clinical Features:

  • Age: a fifth-seventh decade of life
  • Sex: both sexes are equally affected
  • Site
    • The floor of the mouth
    • Retromolar area
    • Buccal mucosa
    • Gingiva
    • Tongue
    • Soft palate
  • Presentation
  • It appears as a small or extensive reel lesion
  • It has well-defined borders

Erythroplakia Types:

  • Homogeneous
    • Has uniform red patches all over
  • Erythroplakia with interspersed patches of leukoplakia
    • Has a few white leukoplakic patches along with a red patch
  • Speckled leukoplakia
    • It is characterized by the presence of soft irregular, raised, erythematous areas with a granular surface

Erythroplakia Differential Diagnosis:

  • Candidiasis: Lesson can be rubbed off
  • Denture stomatitis: The commonly involved site is the palate
  • Tuberculosis: Present of tubercular ulcers
  • Histoplasmosis:  It is common in farmers

Erythroplakia Management

  • Elimination of the causative agent
  • Mucosal stripping of the lesion
  • Laser ablation
  • Electrocoagulation
  • Cryotherocoagulation
  • Maintenance by periodic recall visits every 3 months

Red And White Lesions.

Question 5. Diagnosis of oral lichen planus.

Diagnosis of oral lichen planus

  • Clinical
    • The presence of bilateral interlacing white striae
    • Presence of Wickham striae and Koebner phenomenon
  • Laboratory diagnosis
    • Hyperorthokeratosis
    • Hyperparakeratosis
    • Acanthosis with intercellular edema
    • Civatte bodies
    • The sawtooth appearance of the rete pegs
  • Immunofluorescence
    • Positive reactions with IgA, IgM, and IgG antisera
    • Presence of subepithelial deposits of fibrinogen and antigenically related substances

Question 6. Atrophic candidiasis.

Atrophic candidiasis

Synonym: Antibiotic sore mouth

Atrophic Candidiasis Clinical Features:

  • Site: tongue, tissue underlying the prosthesis
  • Presentation
    • The lesion appears red or erythematous
    • Patients usually have vague pain or a burning sensation
    • Lesion reveals a lew white thickened foci, that are rubbed off leaving a painful surface
    • It closely resembles erosive lichen planus and erythroplakia

Atrophic Candidiasis  Differential Diagnosis:

  • Chemical burn: History of chemicals
  • Drug reaction: Diminished host response
  • Syphilitic mucous patch– Skin lesion is also present
  • Necrotic ulcer and gangrenous stomatitis: Ulcer is deeper
  • Traumatic ulcer: History of trauma present

Atrophic Candidiasis  Management:

  • Elimination of causative agent:
    • Replacement of denture
    • Relining of denture
    • The denture must be cleaned thoroughly and regularly
    • It should be left out of out of the mouth at night in a hypochlorite solution
      • Topical application
  • Clotrimazole:
    • It is an effective topical treatment when dissolved in the mouth for five minutes daily
    • Nystatin Preparation:
      • Dissolves only in the mouth for 5 minutes a day.
  •  Amphotericin B:
      • 5-10 ml of oral solution was used as a rinse.

Question 7. Erosive lichen planus.

Erosive lichen planus

  • It clinically exhibits a mixture of erythematous, ulcerated, and white pseudomembranous areas
  • A faint white zone resembling radiating striae is frequently seen at the junction where the erosive area meets the normal epithelium
  • Most of the lesions develop on the buccal mucosa and the vestibule
  • Patients often complain of severe pain and burning sensation at the time of taking hot and spicy food
  • Patients may restrict themselves to only the bland liquid diet
  • Palpation of the affected mucosa often elicits pain and bleeding
  • The areas of mucosa where the lesion has already healed up exhibit melanotic hyperpigmentation.


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