ORAL PATHOLOGY III
ORAL PATHOLOGY III
11712-324-41

Howard University College of Dentistry

ESTHER L. B. CHILDERS, D.D.S.
Course Director

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ORAL PATHOLOGY III

Lecture Topic Outline
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Discuss specific disease entities that specific disease entities that represent dermatologic disease, with emphasis on the definition clinical emphasis on the definition, clinical features, histological features, treatment and prognosis for each and prognosis for each.

ORAL PATHOLOGY III

Lecture Objectives
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To know the definition, clinical features, histological features, treatment and prognosis for specific examples of dermatologic treatment, and prognosis for specific examples of dermatologic disease. To apply that knowledge to case based problems.
Discuss, define, identify and apply the vocabulary for clinical characteristics of diseases of the oral region through specific disease examples.
Develop the concept of clinical classification of disease based on the clinical characteristics of the lesion and apply that concept to the clinical characteristics of the lesion and apply that concept to the development of differential diagnosis in clinical examples
To develop a differential diagnosis for case examples.
To apply that differential diagnosis toward developing a treatment plan for case examples.

Ectodermal Dysplasia
Ectodermal Dysplasia
• Two or more ectodermal structures fail to develop
– Skin, hair, nails, teeth, sweat glands
– AD, AR, X-linked
AR

• Clinical Features
– Hypohidrotic ectodermal dysplasia dysplasia
• Mostly X-linked
• Heat intolerance
• Sparse hair, periorbital skin hyperpigmentation skin hyperpigmentation, midface hypoplasia, xerostomia, dystrophic nails hypodontia
• Oligodontia, hypodontia

Ectodermal Dysplasia
Ectodermal Dysplasia
• Histopathologic Features
– Decreased number and number and hypoplastic sweat glands and hair follicles

• Treatment and Prognosis
– Genetic counseling
– Dental restoration

White Sponge Nevus
White Sponge Nevus
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Rare, AD genodermatosis
Clinical Features
– Symmetrical, bilateral thick white plaques on mucosa, especially buccal especially buccal
– Extraoral mucosa sites
– Known to be a defect of keratin filaments

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Histopathologic Features
– Hyperparakeratosis, acanthosis, and perinuclear condensation condensation

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Treatment and Prognosis
– No treatment
– Good prognosis prognosis Hereditary Benign Intraepithelial Dyskeratosis
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Rare, AD genodermatosis usually seen in descendants of usually seen in descendants of a triracial isolate in North
Carolina
Clinical Features
– Thick, white plaques of buccal and labial mucosa
– Ocular plaques

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Histopathologic Features
Features
– Hyperparakeratosis and acanthosis – “cell within a cell” dyskeratosis

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Treatment and Prognosis and Prognosis
– No oral treatment, good prognosis – Ocular lesions refer

Peutz
Peutz-Jegher Syndrome
Syndrome
• Rare, AD or spontaneous mutation involve skin and intestine • Clinical Features
– Periorifice skin with brownblack macules
– Intestinal polyps are benign

• Histopathologic Features
Features
– Increased melanin
– Benign intestinal polyps

• Treatment and Prognosis and Prognosis
– Monitor for intussusceptions or malignant transformation

Hereditary Hemorrhagic Telangiectasia
Hereditary Hemorrhagic Telangiectasia
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Rare, AD mucocutaneous disorder
Clinical Features
Features
– Oral lesions often the most easily identified – May present with epistaxis
– Multiple red papules, 1-2mm
– Blanch with diascopy

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Histopathologic Features
– Thin walled vascular spaces walled vascular spaces

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Treatment and Prognosis
– Treatment based on severity of lesions • Laser, skin graft, etc skin graft etc

– May need prophylactic antibiotic coverage Ehlers