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Red and Purple Lesions, Burkhart, N., Delong, L. (2020). Lesions in Shades…
Red and Purple Lesions
Immune System Disorders
Lichen Planus
Characteristics: Reticular form exhibits Wickham striae. Plaque form resembles leukoplakia. Atrophic form appears as red patches. Bulloud form may present as several of the types. Erosive form can be very painful.
Dental Implications: Establishing a home regimen for the patient is important. Scaling and prophy are essential. Non abrasive products are best. Use low settings on ultrasonics to avoid tissue trauma.
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Treatment and Prognosis: Prescribed medication including Fluocinonide, Betamethasone, Clobestol propionate, and corticosteroids.
Etiology: Chronic inflammatory mucocutaneous disease of unknown etiology. Anxiety and Stress may be contributing factors.
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Infections
Candidosis (Candidiasis)
Characteristics: May have a white membrane as well as red color. May appear white with a cottage cheese look on the pharynx, tongue, buccal mucosa, mucosal folds. May wipe lesions off leaving a red, raw ulcer underneath.
Dental Implications: Xerostomia and poor oral hygiene. Focus on OHI for home care so they aren't reinfected.
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Treatment and Prognosis: Treatment of choice is nystatin oral suspension and statin oral powder and clotrimazole oral troches. Reinfection may occur if toothbruses and dentures are not treated. Prognosis depends on the patients state of health.
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Neoplasms
Kaposi Sarcoma
Charcteristics: lesions have a bluish/purple hue in the palatal region. Usually found in the hard palate and gingiva. Starts out as painless, purple-red macules.
Dental Implications: Oral cavity is first site of disease. Bone resorption and tooth mobility might be present.
MoT: Sexual contact, saliva, or transplants.
Treatment and Prognosis: Development in the oral cavity has prognostic implications for untreated HIV patients
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Erythroplakia
Characteristics: May be velvety red or dark pink. Surface areas are varied. May be broad and coalescing, or circumscribed and localized.
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Treatment and Prognosis: Depends on the histological diagnosis. Dyplastic areas are removed. Radiation therapy and chemotherapy may be used.
Etiology: Associated with tobacco and alcohol use, Dietary deficiencies, and lifestyle factors.
Reactive, Traumatic, or Inflammatory Lesions
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Petechiae, Ecchymoses, and Purpura
Characteristics: Do not blanch under pressure. Round purplish spots that appear on the skin. 1-2mm. Purpura, Ecchymoses, and Petechiae may be present as well.
Dental Implications: Identification of blood disease and dyscrasias is important in seeking medical treatment for the patient. Patient may also need special precautions when dental treatment is necessary.
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Treatment and Prognosis: Remove source of trauma. Treat underlying cause. Prognosis depends on the lesion.
Etiology: Hemorrhages of the soft tissue due to trauma or blood dyscrasia. Result of underproduction of platelets in the blood.
Pyogenic Granuloma
Characteristics: Bright red or pink lesions. Can be ulcerated with fibrous tissue changing the color to yellow. Usually found in the Maxillary anterior gingiva. Painless.
She be removed completely to ensure regrowth is impossible. Pregnancy related may clear up on their own. Can occur on children in the lower lip.
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Treatment and Prognosis:May disappear on its own if caused by hormones. Using a carbon dioxide laser has yielded good results. Chemical aids like chlorohexadine gluconate mouth rinses are recommended. Prognosis is excellent.
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Vascular Malformations
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Lymphangioma
Characteristics: Consist of lymphatic vessels and vary in size. Found on the tongue, buccal mucosa, and floor of the mouth, Lesions contain RBC's within channels and lymph tissue. Pulsating may be observed.
Dental Implications: Difficulty swallowing, speech, airway obstruction and mandibular prognathism. Possible deformities of the maxofacial structures.
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Treatment and Prognosis: Usually surgical removal. Sometimes no treatment is needed. If the swelling affects the persons breathing and/or speech, further treatment may be needed.
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Varicosity (Varix)
Veins appear dark blue to purple and may be found on the lingual surface of the tongue. Clinician may determine vascularity by compressing and releasing the area in question.
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Treatment and Prognosis: No treatment needed unless found in the lip or buccal mucosa and is of concern cosmetically to the patient. Formation of a thrombus warrants surgical removal Prognosis is excellent.
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Burkhart, N., Delong, L. (2020). Lesions in Shades of Red and Purple. In GENERAL AND ORAL PATHOLOGY FOR THE DENTAL HYGIENIST {309-328}. S.I.: JONES & BARTLETT LEARNING