Download - Description of Lesions
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Description of Lesions1800 Introduction to Clinical Procedures
Tiffany Baggs, RDH, BASDH
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Lesions of all kinds Elevated Lesions Depressed Lesions Flat Soft Tissue Lesions
All lesions: Single or Multiple
Wilkins page 151-156
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Elevated Lesions Blisterform: fluid filled, soft and
translucent Vesicle: small 1cm or less, serum or
mucin Pustule: any size, pus, yellowish Bulla: large 1 cm or more, serum or
mucin, blood
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Elevated Lesions Nonblisterform: solid lesion, no fluid,
firm Plaque: “pasted on appearance” Papule: small, solid, pointed, rounded or
flat topped, Nodule: larger than a papule greater than
5 mm less than 1 cm Tumor: 2 cm or greater, general swelling
or enlargement
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Papules, Nodules, TumorsTake note of the base of lesion Pedunculated: attached to narrow stalk
Sessile: base as wide as lesion
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Depressed Lesions Below the level of the skin or mucosa
Ulcer: loss of continuity of the epithelium, gray to yellow, surrounded by red
Erosion: shallow, depressed lesion that does not extend through the epithelium
Regular / Irregular Outline Smooth / Raised Margin Superficial / Deep
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Flat Lesions or macule Single macule or Mulitiple macules
Regular / Irregular
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Other Descriptions Crust Erythema Exophytic Indurated Papillary Petechiae Pseudomembrane Polyp Punctuate Torus Verrucous
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Oral Cancer Any patient Red flag:
Tobacco use Alcohol use Sun exposure
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Discovery- the earlier the better Head, Neck, Oral Examination
Every appointment/Document Common site
Floor of the mouth Tongue lateral border Lower lip Soft Palate (gingiva, buccal mucosa, oropharynx)
Self-examination for Patients
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Many forms White areas Red Areas Ulcers Masses Pigmentation
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Area to be watched, documented If area does not change/heal, what do
we do?
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Return in two weeks Biopsy: removal and examinations of a
sections of tissue Cytologic smear: surface cells are
removed Not biopsied- patient refuses biopsy
Referral out for biopsy: dermatologist, oral surgeon
Exfoliative cytology
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Oral Cancer Detections Systems Velscope
ViziLite
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Velscope http://velscope.com/about_velscope/
Cordless, portable and rechargeable: “ring of light” illumination
healthy cells in the mouth fluoresce= emitting a bright green glow
Unhealthy cells , lack of fluorescence= appearing dark when viewed against the healthy tissue.
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ViziLite http://www.zila.com/40/VIZILITE%26REG%3B%20PLUS/
slightly desicates the cells to make the nuclei more prominent, more visible
low intensity light from the handheld light source is reflected off of these abnormal cells down to the basement membrane where the nuclei have been rendered more prominent, and appear to "glow" – making abnormal cells easier to see.
Mouthrinse, dyes Patient rinses with a solution for 1 minute, expectorates, lights
are dimmed or special glasses used, handheld light stick is used
Suspicious areas turn a blue color
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Documentation (A,B,C,D,&T) Anatomic location
where is it? Border
demarcated? Regular or irregular? Color change configuration
Color, patter? Diameter/dimension
Irregular, oblong: length x width Circular: diameter
Type Flat Elevated Fluid filled Loss of skin/mucosa
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Documentation Have a baseline Note what kind of lesion Follow up appointments- note any
changes For legal purposes be as detailed as
possible.
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Teach Patient Self examination Diet, nutritional effects on health Oral health tends to reflect general
health
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Warning Signs of Oral Cancer Swelling, lump, or growth – with or without pain White scaly patches Red velvety areas Sores that do not heal in 2 weeks Numbness, tingling Excessive dryness or wetness Hoarseness, sore throat, persistent coughing or
feeling of “lump in the throat” Difficulty swallowing Difficulty in opening the mouth
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THE END…………..