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Erythroplakia

Erythroplakia. Nick Matthews Oral Medicine and Diagnosis Case Study UMKC School of Dentistry Fall 2010. Pt # 497-6-81 67 y.o. Caucasian male Routine Dental Exam Medical Hx: Pennicillin Allergy Hypertension Central Venous Stent or Catheter NIDDM: HbA1c = 6.1 Hx of Gout

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Erythroplakia

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  1. Erythroplakia Nick Matthews Oral Medicine and Diagnosis Case Study UMKC School of Dentistry Fall 2010

  2. Pt # 497-6-81 • 67 y.o. Caucasian male • Routine Dental Exam • Medical Hx: • Pennicillin Allergy • Hypertension • Central Venous Stent or Catheter • NIDDM: HbA1c = 6.1 • Hx of Gout • Previous Tobacco Use • Hx of Osteomyelitis in R mand causing loss of 2 teeth • Hx of Tongue biopsy which returned as Displaysia. • Pt on high dose of Plavix • Takes Aspirin daily Patient Info

  3. Patient presents with bilateral diffuse, erythematous flat macules on ventral surface of tongue. The lesion appears to involve the tissues below the epithelium. Lesion Description

  4. Erythroplakia

  5. Erythroplakia

  6. How long have these lesions been present? • - Unknown • Have you had any pain associated with these lesions? • - No • Do you drink much alcohol? • - No • Do you still smoke? • - No • Do you know if you have any habits or behaviors that might cause these lesions? • - No Dialogue with Patient

  7. Erythroplakia = a persistent red patch that can’t be characterized as any other condition • No histologic connotation • Most can histologically be diagnosed as epithelial dysplasia or worse • Areas of Erythroplakia have an increased rate of progression to carcinoma • There are 3 types of Erythroplakia: • Homogenous Form • Erythroleukoplakia • Specialized Erythroplakia About Erythroplakia

  8. Patient is currently waiting for biopsy. The patient had 3 stents placed in April, and is on a heavy dose of Plavix, as well as a daily regimen of aspirin. The patient’s cardiologist refused to allow for a drug holiday for the patient to have the biopsy taken, and based on the patient’s Bleeding Time, the biopsy can not be taken in our clinic while the patient is on the current regimen of Plavix and Aspirin. • The patient and his wife are eager to have the biopsy and are considering a stay in the hospital so that the patient can be under direct medical supervision while he is on drug holiday from his Plavix and aspirin. • A complete diagnosis can not be made without the biopsy. Patient Status

  9. Physical Trauma • Chemical Burns • Infectious or Non-Infectious Mucositis • Epithelial Dysplasia • Carcinoma In-situ • Squamous Cell Carcinoma Differential Diagnosis

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