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."
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