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Red-Blue Lesions (Ch12) - Coggle Diagram

- - - - Found on the gingiva or edentulous ridge usually mesial of molar region; 1 to 2 cm; normally deep red or bluish purple any more bluish then pyogenic granuloma, which is often a deep red; soft too firm; may show ulceration and bleed; similar to pyogenic granuloma
    - - DPGCG can cause bone resorption (unlike pyogenic granuloma; potentially seen on radiograph if on edentulous ridge
    - - Not transmissible or contagious
    - - After entire removal, prognosis is excellent; periosteum and PDL must be removed with lesion to avoid reoccurrence; local irritant must be subdued
    - - Reactive hyperplastic response to tissue injury, producing and exuberance of tissue
  - - - Outside the mouth when pressure is applied, lesions do not blanch since hemorrhage is blood that has pooled in the area; If blanching occurs lesion might be vascular and blood would stop flowing to the area Petechiae are tiny, perfectly round, purplish-red spots - a result of minute intradermal or sub mucosal hemorrhage; Purpura is a focal, circumscribed hemorrhage larger than a petechia and less than 1 cm; Ecchymoses is a hemorrhage spot caused by the extravasation of blood into subcutaneous tissue - larger than purpura; measures over 1 cm
    - - Identification of blood disease and dyscrasias is important; patient under care for a blood disease may need special precautions for dental treatment
    - - Not transmissible or contagious
    - - Greatest need is to treat underlying cause or remove source of trauma; prognosis depends on calls; lesions associated with trauma usually subside in a week or more when offending source is removed
    - - Hemorrhages in soft tissue due to either trauma or blood dyscrasias
  - - - Can occur outside the mouth on mucosal surfaces such as the eye,colon, or skin. Usually bright red in the mouth but can be from pink to red. Tissue may be ulcerated and replaced with fibrous tissue making it yellow; pedunculated or sessile depending on location and cause; may be lobular, smooth, or papillary. Usually occurs on MX anterior gingiva (75% of time), lower lip, tongue, buccal mucosa; are painless; without exudate.
    - - Should be completely cut out so as not to reoccur; usually occurring during pregnancy related to hormonal changes; shrinks or completely diminishes after pregnancy; trauma on the lip due to granuloma may occur; may lead to mucocele
    - - Not transmissible or contagious
    - - Usually subsides on its own if due to pregnancy; surgical removal otherwise; chlorhexidine gluconate mouth rinses are recommended; thorough scaling procedures, warm, salt water rinses; prognosis is excellent
    - - Thought to be from multiple etiologies such as drugs, hormones, foreign irritants, and systemic illness like leukemia.
- - - - Cutaneous lesions present as keratotic violaceous, pruritic plaques mostly on flexor surfaces; reticular form is classic where lesions exhibit white striae (Wickham striae); other forms are papular, plaque, atrophic, bullous, and erosive; usually a combination of forms is seen clinically; may possibly seed like lichenoid reaction (rxn to dental product)
    - - Stress home care regimen; professional scaling and prophy are essential; avoiding irritating agents is important; air polishers are not recommended
    - - Not transmissible or contagious
    - - Corticosteroids, but beware of possible candidiasis
    - - Chronic, inflammatory mucocutaneous disease; unknown etiology; behaves like type IV hypersensitivity reaction i.e. cell-mediated immune response; some classify as autoimmune disease
  - - - Gingiva appears fiery red and somewhat bulbous; velvety red appearance with distinctive clearing in areas where products do not contact the tissue e.g. oral vestibule
    - - With any red, blue, or purple lesion, underlying cause must be found. Determine source and discontinue contact with offending product
    - - Not transmissible or contagious
    - - Correct diagnosis is usually through trial and error in case of toothpaste or food allergy a response is usually evident within two weeks; prognosis is excellent and hypersensitivity agent is identified and discontinued
    - - Appear to be delayed cell-mediated immune responses; not classic type 1 response associated with angioedema; Plasma cell gingivitis an allergic gingivostomatitis are associated with allergic responses to substances; Contact allergies and sensitivity to food products, flavoring agents, dental hygiene products, and restorative products, sodium benzoate, tartrazine, food and cosmetic additives
- - - - Can be due to loss of teeth and sagging tissue at the commissures
    - - Common risk factors include xerostomia and poor oral hygiene
    - - Not transmitted to others unless that person is susceptible; HIV and AIDS patients are especially vulnerable to the organism; as our chemotherapy and radiation treatment patients
    - - Treatment of choice is nystatinn oral suspension, nystatin oral powder, and clortrimazole oral troches; for angular colitis nystatin ointment; Ensure appliances toothbrushes and dentures are cleaned well using chlohexidine and nystatin solution
    - - Species of the genus Candida; C. albicans being the most common
- - - - Deep velvety red color or dark pink; surface areas are varied, sometimes appearing corrugated or pebbly; sometimes very smooth; maybe broad and coalescing or circumscribed and localized; has many appearances
    - - Should be assessed for cancer cells via biopsy; greatest concern is when to biopsy; lesion should be guarded, watched carefully, or biopsied; on initial detection clinician may want to use abnormal cell detection device; Any lesion that does not subside after two weeks warrants a biopsy
    - - Not contagious or transmissible
    - - Treatment depends on histologic diagnosis; follow ups for any potentially malignant lesion should be performed at 1-, 3-, 6-, and 12 month intervals
    - - Associations include use of tobacco and alcohol use, dietary deficiency's and lifestyle factors, and chronic friction and exposure to irritants producing chronic inflammation
- - - - Color will vary from dark pink and the deeper tissue to dark purple in superficial areas; Intraorally usually appears as a deep blue to read enlargement with a raised appearance; seem to occur more frequently on tongue, lips, and buckle mucosa; hemangiomas will blanch with pressure so as to distinguish it from hematoma through diascopy
    - - The only foreseeable problem is the formation of a thrombus; if thrombi exhibit calcification (phlebolith) it may need to be surgically removed
    - - Not transmissible or contagious
    - - Most require no treatment; prognosis is excellent
    - - Benign proliferation of blood vessels; found in infancy and childhood; maybe a hamartoma or malformation; composed of capillaries and venues
  - - - May have connection between enlarged veins in legs and lingual varicosities; veins appear dark blue to purple; found on lingual surface of the tongue, lips, or buccal mucosa
    - - No specific Dental implication other than the appearance
    - - No transmission factor
    - - No treatment required
    - - Acquired vascular malformation; thought to be developmental abnormality; association exist between varicosities found orally and those found in the legs of adults
  - - - Skin lesions can appear on palms, fingers, nail beds, face, and neck; lesions are usually bright red and occurring on the lips and anterior tongue, can rupture, hemorrhage, and appear as an ulcer when traumatized; papules are about 1 to 2 mm in size and will usually blanch; frequent epistaxis and spider veins are characteristic
    - - Lesions usually bleed profusely when traumatized; consideration of a more serious disease should be given depending on severity and extent; patient may be premedicated
    - - Not contagious
    - - Prognosis depends on severity; patient must be monitored throughout life and severe forms; anemia could result; preventing hemorrhage is crucial
    - - Genetic, autosomal dominant; Dilated blood vessels appearing as "spider veins "; small collections of dilated capillaries; includes four diagnostic criteria