PANCE Blueprint EENT (7%)

Other oropharyngeal disorders (Pearls)

NCCPA™ PANCE EENT Content Blueprint  Oropharyngeal disorders  other oropharyngeal disorders

Patient will present as → a 42-year-old male with symptoms of the flu. On social history, the patient describes drinking 2-3 beers per day as well as smoking 1 pack of cigarettes per day. He is noted on physical exam to have a white plaque-like lesion on the side of the tongue which could not be scraped off with a tongue depressor.

Oral leukoplakia is an oral potentially malignant disorder that presents as white patches of the oral mucosa that cannot be wiped off with a gauze

  • Tobacco use (smoked and especially smokeless), alcohol abuse, HPV infections
  • Leukoplakia is in itself a benign and asymptomatic condition. However, some patients will eventually develop squamous cell carcinoma (SCC)

TX: Biopsy and surgical excision

  • Destructive therapies (eg, laser ablation, cryosurgery), medical therapies (eg, retinoids, vitamin A, carotenoids, NSAIDs), and watchful waiting with close clinical and histologic follow-up
Patient will present as → a 42-year old patient with AIDS presents with a grayish-white “corduroy-like” plaque on the lateral borders of her tongue that does not scrape off.

Oral hairy leukoplakia is a separate disorder that is not premalignant. It is an Epstein-Barr virus-induced lesion that occurs almost entirely in HIV-infected patients

  • Generally affects the lateral portions of the tongue, although the floor of the mouth, the palate, or the buccal mucosa may also be involved

TX: Unlikely to progress to squamous cell carcinoma

  • Treatment with zidovudine, acyclovir, ganciclovir, foscarnet, and topical podophyllin or isotretinoin
  • Therapy is usually not indicated
"Thrush can be scraped off with a tongue depressor revealing inflamed mucosa underneath. Leukoplakia will remain intact when attempting to remove with a tongue depressor."
Oropharyngeal trauma (Prev Lesson)
(Next Lesson) Oral leukoplakia
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