CLINICAL DESCRIPTIVE TERMS
Author: Sanketh DS, MDS
All clinicians should be familiar with the descriptive terms used to describe any lesion. The clinician, by doing so can efficiently and uniformly describe a lesion, which could also help in listing them with respect to differential diagnosis.
Focal/circumscribed area of the mucosa, that can be distinguished from its surroundings by its colour. It is neither elevated nor depressed and can be blue,brown or black in colour. This term is reserved for lesions that are 1 cm or smaller in size.
Eg – Oral melanotic macule
Focal/circumscribed area of the mucosa, that can be distinguished from its surroundings by its colour. A patch is neither elevated nor depressed and is greater than 1cm in size(larger than macule).
Eg – Mucous patches in syphilis, melanoacanthoma
Is a solid raised lesion greater than 1cm in diameter and has the dimension of depth and extend deeper into the connective tissue.
Eg – Benign mesenchymal tumors like neuroma, fibroma,lipoma
Is a circumscribed elevated fluid filled blister that is under 1 cm in diameter. Vesicles may contain serum or lymph or may sometimes be filled with blood. Vesicles may breakdown to give rise to ulcers or erosions.
Eg – May be seen in herpes simplex, herpes zoster
Is a circumscribed elevated fluid filled blister greater than 1 cm in diameter. Usually occurs as a result of accumulation of fluid in the epithelium-connective tissue interface or a split in the epithelium.
Eg – are seen in pemphigus, pemphigoid, erythema multiforme
Is a circumscribed elevated blister that develops due to accumulation of purulent exudate (pus). Are usually less than 1 cm in diameter and appear creamy white to yellowish in colour.
Eg- May appear in herpes zoster, vesicullo-bullous lesions like pemphigus
Are lesions that usually arise as a result of rupture of a vesicle or bulla. Erosions are moist and slightly depressed, and are superficial denudations of the epithelium (above the basal layer).
Eg- may be seen in pemphigus, pemphigoid, oral lichen planus
Are well circumscribed, depressed lesions with a break in the continuity of the epithelium. The disruption in the epithelium extends beyond the basal layer and into the connective tissue. Ulcers are usually painful.
Eg – may be seen in vesicullo-bullous lesions, viral infections like herpes simplex,herpangina, apthous stomatitis
This may be a normal or abnormal linear slit in the epithelium, that usually occurs in the lips and perioral tissues. It may harbour inflammation and ulcerations if infected.
Eg- Angular cheilitis, Exfoliative cheilitis
Is a term usually representing a neoplasm, is used to describe any solid tissue enlargement. Tumors often appear as raised rounded lesions and have dimensions of depth. However, it is usually avoided as a clinical descriptive term and terms like “nodule”, “mass” or “swelling” are preferred.
Eg- neurofibroma, granular cell tumor, fibroma
Is defined as a pathological cavity, lined by epithelium, having fluid, semifluid or gaseous content that are not created by the accumulation of pus. Their size may range from a few millimetres to few centimetres.
Eg – radicular cyst, dermoid cyst, lymphoepithelial cyst, naso-alveolar cyst
Is dried blood, serum and other exudates covering an ulcerated area. This area is termed as a pseudomembrane if its moist!
Eg- Erythema multiforme, other vesicullo-bullous lesions, herpes simplex
Are minute pin-point haemorrhages into the skin/oral mucous membrane that may be 1-2mm in diameter. Usually occurs when there is increased vascular pressure or low platelet counts (thrombocytopenia).
These are haemorrhages that are slightly larger than petechiae (> 3mm). They are associated with the same diseases causing petechiae.
Are haemorrhages (bruises) larger than purpuras (>1 to 2cm).
The term “verrucous” refers to wart like projections on the surface of a lesion.
Eg – Verrucous carcinoma, Verrucous leukoplakia
The term “papillomatous” refers to cauliflower like or nipple like projections on the surface of a lesion. They are often pedunculated.
Eg – squamous papilloma, verucca vulgaris, condyloma acuminatum
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