Oral Pathology in the Pediatric Patient A Clinical Guide to the Diagnosis and Treatment of Mucosal Lesions 1st Edition by Elizabeth Philipone, Angela Yoon ISBN 331944638X 9783319446387

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Product details:

ISBN 10:       331944638X
ISBN 13: 978-3319446387
Author:         Elizabeth Philipone, Angela J. Yoon

This book is a practical, user-friendly guide to the clinical diagnosis and treatment of the oral mucosal lesions most frequently encountered in pediatric patients. For each entity, a characteristic clinical photograph is provided, the clinical appearance is concisely described, and guidance is offered on differential diagnosis and treatment options. Oral indications of systemic diseases are addressed in a separate section, and mucosal indicators of drug use, sexual abuse, and eating disorders are also identified.

Oral lesions are a relatively common occurrence in the pediatric population. Fortunately, most of these lesions are transient and can be diagnosed clinically; examples include aphthous ulcers, traumatic ulcers, and lesions of infectious etiology such as viral lesions and candidiasis. There are also a number of mucosal lesions, such as mucoceles and viral papillomas, that require biopsy for diagnosis and/or surgical excision for treatment. This book will assist the practitioner in diagnosing and treating both transient and persistent mucosal lesions.

Oral Pathology in the Pediatric Patient: A Clinical Guide to the Diagnosis and Treatment of Mucosal Lesions 1st  Table of contents:

Oral Lesions and the Pediatric Patient

Understanding oral lesions in children is crucial for early diagnosis, appropriate treatment, and managing underlying health issues. Pediatric patients often present with distinct types of oral lesions that may vary in appearance, etiology, and implications.

Types of Oral Lesions

1. Mucosal Lumps and Bumps with Smooth Surfaces

   • These lesions are often benign and can appear as small, raised, smooth bumps on the oral mucosa.
   • Common conditions include:
     • Mucocele: A cyst-like lesion caused by the rupture of a salivary gland duct.
     • Fibroma: A benign tumor made of fibrous tissue, often as a result of chronic irritation or trauma.
     • Lipomas: Fatty tissue growths, less common in the oral cavity.
   • Management: Typically involves observation for benign lesions, with surgical removal in cases of discomfort or aesthetic concerns.

2. Papillary Lesions

   • Characterized by elevated, finger-like projections on the mucosal surface.
   • Conditions include:
     • Papillomas: Benign epithelial growths, often caused by the human papillomavirus (HPV).
     • Hyperplastic Lesions: Overgrowth of tissue due to chronic irritation or inflammation.
   • Management: Surgical excision for diagnosis and treatment, with possible follow-up to monitor recurrence.

3. Oral Ulcerations

   • Painful lesions with a break in the mucosal surface, often surrounded by an erythematous halo.
   • Common types:
     • Aphthous Stomatitis (Canker Sores): Recurrent, small ulcers that appear on the mucosal surfaces, not caused by infection.
     • Traumatic Ulcers: Resulting from physical injury or irritation (e.g., biting the cheek or braces).
     • Viral Infections: Herpes simplex virus (HSV) can cause oral ulcers.
   • Management: Supportive care for pain relief, topical medications, and addressing underlying causes (e.g., trauma, infection).

4. White Macules & Patches

   • These lesions present as white areas on the mucosal surface.
   • Conditions include:
     • Leukoplakia: A potentially precancerous lesion often linked to irritation or tobacco use.
     • Lichen Planus: An autoimmune disorder presenting as white, lacy patches.
     • Candidiasis: A fungal infection that can appear as white patches, often seen in immunocompromised children.
   • Management: Diagnosis through biopsy and culture, with treatment depending on the underlying cause (e.g., antifungals for candidiasis, corticosteroids for lichen planus).

5. Red Macules & Patches

   • These are red, flat lesions that can indicate inflammation, infection, or other systemic conditions.
   • Common causes:
     • Erythema Multiforme: A skin and mucosal condition triggered by infections or medications, characterized by red lesions.
     • Gingivitis: Inflammation of the gums due to plaque buildup, often presenting as red, swollen gums.
     • Viral Infections: Such as hand, foot, and mouth disease, presenting as red lesions in the mouth.
   • Management: Treatment involves addressing the underlying infection or inflammation, with oral hygiene and medication as necessary.

6. Pigmented Lesions

   • Lesions characterized by dark or brown spots on the oral mucosa.
   • Common types include:
     • Focal Pigmentation: Often related to genetics or medications.
     • Melanocytic Nevi: Benign moles or birthmarks found on the oral mucosa.
     • Melanoma: A rare but serious malignant tumor, often dark in color.
   • Management: Requires careful monitoring, with biopsy to rule out malignancy if necessary.

7. Gingival Lesions

   • Lesions affecting the gums, which can be indicative of local or systemic issues.
   • Common conditions:
     • Gingivitis: Inflammation of the gums due to poor oral hygiene or systemic factors.
     • Pyogenic Granuloma: A benign growth that can occur during pregnancy or due to hormonal changes.
     • Periodontal Abscess: A localized infection in the gums or bone, often presenting as a painful swelling.
   • Management: Focus on improving oral hygiene, treating underlying infections, and possibly surgical intervention.

Oral Indications of Systemic Diseases

• Oral manifestations can be a reflection of systemic conditions:
  • Vitamin Deficiencies: Such as vitamin C (scurvy) or B vitamins, which can cause oral ulcers, bleeding gums, and mucosal changes.
  • Systemic Lupus Erythematosus (SLE): Can cause oral ulcers, mucosal lesions, and other symptoms.
  • Diabetes Mellitus: May result in dry mouth, gingivitis, and an increased risk of infections.
  • HIV/AIDS: Oral lesions such as Kaposi’s sarcoma, candidiasis, and aphthous ulcers are common in pediatric patients with compromised immune systems.
• Management: Referral to a pediatrician or specialist for systemic management, alongside oral care and treatment.

Other

• Trauma and Injury: Oral lesions caused by accidents, such as burns, cuts, or bites.
• Oral Manifestations of Allergies: Including swelling, erythema, and itching of the mucosa due to food or medication allergies.
• Medication-Induced Lesions: Some medications (e.g., antibiotics, antiseizure medications) can cause oral lesions as side effects.

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