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LIP, FACE, VESTIBULE. David E. Wojtowicz, DDS, MBA. WHITE RED ULCER. EXOPHY-TIC DEVELOP-MENTAL. LIP. LIP WHITE. Candidiasis Squamous Cell Carcinoma Actinic Cheilitis Smoker’s Keratosis. LIP RED & PIGMENTED. Angular Cheilitis (= Perleche) Candidiasis @ Commissure Hemangioma
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LIP, FACE, VESTIBULE David E. Wojtowicz, DDS, MBA
WHITE RED ULCER EXOPHY-TIC DEVELOP-MENTAL LIP
LIPWHITE • Candidiasis • Squamous Cell Carcinoma • Actinic Cheilitis • Smoker’s Keratosis
LIPRED & PIGMENTED • Angular Cheilitis (= Perleche) • Candidiasis @ Commissure • Hemangioma • Labial Melanotic Macule (=Ephelis)
LIP ULCERS • Traumatic • Herpetic • Erythema Multiforme • Hypersensitivity (Herpes, Sulfa) Reaction of Skin (Bull’s Eye) and Mucosa (Ulceration)
LIP EXOPHYTIC / ELEVATED • Fibroma • Papilloma • Mucocele • Angioedema
LIPDEVELOPMENTAL • Commisural Lip Pit
BUCCAL AND LABIALVESTIBULE • White • Red • Ulcer • Anatomy
Linea Alba Cheek Bite Snuff Dipper’s Aspirin Burn Leukoedema White Sponge Nevus Lichen Planus SCC Fordyce’s Granules VESTIBULEWHITE
Linea Alba Cheek Bite Snuff Dipper’s Aspirin Burn Leukoedema White Sponge Nevus Lichen Planus SCC Fordyce’s Granules VESTIBULE WHITE
VESTIBULEEXOPHYTIC • Stensen’s Papilla • Parulis
VESTIBULERED / PIGMENTED • Erosive Lichen Planus • Amalgam Tattoo
VESTIBULEULCER • Apthous • Traumatic
Actinic Keratosis S C C Keratoacanthoma Basal C C Systemic Lupus Rosacea Herpes Zoster Nevus Melanoma Neurofibroma DERMATOLOGIC LESIONS • Seborrheic Keratosis • Senile Sebaceous Hyperplasia • Trichoepithelioma • Syringoma • Sebaceous Cyst • Epidermal Cyst
Actinic Keratosis S C C Keratoacanthoma Basal C C Seborrheic Keratosis Sebaceous Hyperplasia Trichoepithelioma Syringoma Sebaceous Cyst Epidermoid Cyst Milia Systemic Lupus Rosacea Herpes Zoster Nevus Melanoma Neurofibroma DERMATOLOGIC LESIONS LIST
ACTINIC KERATOSIS • Sun Damaged Skin • Scaling, Kertotic, & Erythematous • Appears Gray to Deep Brown • Premalignant
S C C • Resembles B C C • Enlarging Ulceration • Central Crust • Indurated Base • Regional & Distant Metastasis • M > F
KERATOACANTHOMA • Resembles S C C • “Self Healing Carcinoma” • Pink Dome > Keratin Plug > Crater >Healing • May Exhibit Aggressive Destruction of Tissue
BASAL C C • Nodulo Ulcerative: Translucent Papule >Enlarges Slowly > Central Depression >Firm Border >Ulcerates • Men >40
SEBORRHEICKERATOSIS • Elevated, Verrucous • Brown, Black, Greasy • “Stuck On” • Older Individuals
SEBACEOUSHYPERPLASIA • Elevated • Soft • Flesh or Yellow Color • Central Punctum • Forehead • Middle Age
TRICHOEPITHELIOMA • Hair Follicle Lesion on Upper Face • Flesh-Colored Papule • Dome-Shaped • Adjacent to Nose
SYRINGOMA • Multiple Papules • Pebble Like • Flesh or Yellow Color • Upper & Lower Eyelids • Adenoma of Sweat Ducts • Onset in Adolescence
SEBACEOUS CYST • Dome Shaped • Superficial • Hair Bearing Area • Slow Growing • Surgical Removal
EPIDERMOID CYST • Follicular Cyst (Hair Follicle) • Elevated, Firm • Central Pore • Thick Keratinous Contents • Slow Growing • 0.2 - 5 cm
MILIA • Tiny Epidermoid Cysts (1 - 2 mm) • Contains Keratin • Around Eyes
SYSTEMIC LUPUS • Butterfly Rash
ROSACEA • Erythema of “Flush Area” • Chronic Acne • Mimics Lupus • F > M, 20 to 60 Years
HERPES ZOSTER • Vesicles > Erythema > Crust • Unilateral Distribution Along Innervation