Pedro Diz Dios is Professor and Head of Special Needs Dentistry at the School of Medicine and Dentistry, Santiago de Compostela University, Spain. He is also Honorary Visiting Professor at the Eastman Dental Institute, University College London, UK.

Crispian Scully CBE is a Director of the WHO Collaborating Centre for Oral Health-General Health and Emeritus Professor at the Eastman Dental Institute, University College London, UK. 

Oslei Paes de Almeida is Professor of Oral Pathology and Medicine at the Department of Oral Diagnosis, Dental School of Piracicaba, University of Campinas, São Paulo, Brazil. He is also Visiting Professor at both the University of Bristol and University College London, UK.

José V. Bagán is Professor of Oral Medicine at Valencia University and Head of Stomatology and Maxillofacial Surgery Service at University General Hospital, Valencia, Spain. 

Adalberto Mosqueda Taylor is Professor of Oral Pathology and Medicine at the Health Care Department, Universidad Autónoma Metropolitana Xochimilco and Professor of Oral Medicine at the Hospital General Dr. Manuel Gea González in Mexico City, Mexico.

Preface vii

About the companion website

1 Examination of extraoral tissues 2

Head and neck 3

Cranial nerves 3

Limbs 3

2 Examination of mouth, jaws, temporomandibular region and salivary glands 4

Mouth 5

Jaws 5

Temporomandibular joint (TMJ) 5

Salivary glands 5

3 Investigations: Histopathology 6

Mucosal biopsy 7

Brush biopsy 7

Labial salivary gland biopsy 7

4 Investigations: Microbiology 8

5 Investigations: Imaging 10

6 Investigations: Blood tests 12

Referring a patient for specialist opinion 12

7 Anatomical variants and developmental anomalies 14

Fordyce spots (“Fordyce granules”) 15

Fissured tongue (scrotal or plicated tongue) 15

Stafne cyst or bone cavity 15

Torus palatinus 15

Torus mandibularis 15

Varicosities 15

8 Blisters 16

Angina bullosa hemorrhagica (localized oral purpura; traumatic oral hemophlyctenosis) 17

9 Blisters, infections: Herpes simplex virus 18

Herpes simplex 18

Recurrent herpes labialis 19

Recurrent intraoral herpes 19

10 Blisters infections: Varicella zoster virus 20

Chickenpox (varicella) 21

Zoster (shingles) 21

11 Blisters, skin diseases: Pemphigus 22

Pemphigus 23

12 Blisters, skin diseases: Pemphigoid 24

13 Pigmented lesions 26

Superficial discoloration 26

Hairy tongue (black hairy tongue; lingua villosa nigra) 27

14 Pigmented lesions: Ethnic pigmentation and tattoos 28

Ethnic pigmentation 29

Foreign body tattoos 29

15 Pigmented lesions: Melanotic macule 30

16 Pigmented lesions: Nevus and others 31

Adenocorticotrophic hormone effects (ACTH) 31

17 Pigmented lesions: Malignant melanoma 32

18 Red and purple lesions 34

Purpura 34

19 Red and purple lesions: Desquamative gingivitis, mucositis 35

Desquamative gingivitis 35

Mucositis 35

20 Red and purple lesions: Erythematous candidosis 36

Acute candidosis 36

Chronic candidosis 37

Denture-related stomatitis (denture sore mouth; chronic atrophic candidosis) 37

Angular stomatitis (angular cheilitis; perleche) 37

Median rhomboid glossitis (central papillary atrophy of the tongue) 37

21 Red and purple lesions: Angiomas 38

Hemangioma 38

Venous lake (venous varix; senile hemangioma of lip) 38

Lymphangioma 38

22 Red and purple lesions: Proliferative vascular lesions, Kaposi sarcoma 39

Proliferative vascular lesions 39

Kaposi sarcoma 39

23 Red and purple lesions: Erythroplakia 40

Erythroplakia (erythroplasia) 40

24 Red and purple lesions: Erythema migrans (lingual erythema migrans; benign migratory glossitis; geographical tongue; continental tongue) 41

25 Swellings: Hereditary conditions, drug-induced swellings 42

Hereditary gingival fibromatosis (HGF) 43

C1 esterase inhibitor deficiency (hereditary angioedema) 43

Drug-induced gingival swelling 43

26 Swellings: Infections, human papilloma virus 44

Papilloma 44

Warts (verrucae) 45

Multifocal epithelial hyperplasia (Heck disease) 45

Koilocytic dysplasia 45

HPV and oral cancer 45

27 Swellings: Granulomatous conditions 46

Sarcoidosis 46

Crohn disease and orofacial granulomatosis 46

28 Swellings: Reactive lesions 48

Denture-induced hyperplasia (epulis fissuratum) 49

Fibroepithelial polyp (fibrous lump) 49

Fibroma 49

Giant cell epulis (peripheral giant cell granuloma) 49

Pyogenic granuloma 49

29 Swellings: Malignant neoplasms, oral squamous cell carcinoma (OSCC) 50

30 Swellings: Malignant neoplasms, lymphoma, metastatic neoplasms 52

Lymphomas 53

Metastatic oral neoplasms 53

31 Ulcers and erosions: Local causes, drug-induced ulcers 54

Local causes 54

Eosinophilic ulcer (traumatic eosinophilic granuloma; traumatic ulcerative granulomatous disease) 54

Drug-induced ulcers (stomatitis medicamentosa) 55

32 Ulcers and erosions: Aphthae 56

33 Ulcers and erosions: Aphthous-like ulcers 58

Behçet syndrome (BS, Behçet disease) 59

34 Ulcers and erosions: Blood diseases, gastrointestinal disorders 60

Blood diseases 60

Leukemias 60

Gastrointestinal disorders 61

Celiac disease (gluten sensitive enteropathy) 61

35 Ulcers and erosions: Infections 62

Hand, foot and mouth disease (HFM; vesicular stomatitis with exanthem) 62

Herpangina 62

Bacterial infections 63

Acute necrotizing ulcerative gingivitis (Vincent disease; acute ulcerative gingivitis, AUG, ANG, ANUG) 63

Syphilis 63

Gonorrhea 63

Tuberculosis 63

36 Ulcers and erosions: Erythema multiforme, toxic epidermal necrolysis and Stevens-Johnson syndrome 64

Erythema multiforme 65

Toxic epidermal necrolysis (TEN, Lyell syndrome) and Stevens-Johnson syndrome (SJS) 65

37 White lesions: Candidosis (candidiasis) 66

Acute pseudomembranous candidosis 66

Chronic hyperplastic candidosis (Candidal leukoplakia) 67

Chronic mucocutaneous candidosis (CMC) 67

38 White lesions: Keratosis, leukoplakia 68

Tobacco-related keratosis 69

Leukoplakia 69

39 White lesions: Hairy leukoplakia, lichen planus 70

Hairy leukoplakia 70

Lichen planus (LP) and lichenoid reactions 71

40 Salivary conditions: Salivary swelling and salivary excess 72

Salivary swelling 73

Saliva excess (sialorrhea, hypersialia, hypersalivation, ptyalism) and drooling 73

41 Salivary conditions: Dry mouth 74

42 Salivary conditions: Sjögren syndrome 76

43 Salivary conditions: Sialolithiasis, sialadenitis 78

Sialolithiasis 78

Sialadenitis 78

Sialadenitis: Acute viral (mumps) 78

Sialadenitis: Acute bacterial ascending 79

Sialadenitis: Chronic bacterial 79

Sialadenitis: Recurrent parotitis of childhood 79

44 Salivary conditions: Neoplasms 80

Benign neoplasms (adenomas) 81

Malignant neoplasms 81

45 Salivary conditions: Mucoceles, sialosis 82

Mucoceles (mucous cyst; mucus extravasation phenomenon; myxoid cyst) 83

Sialosis (sialadenosis) 83

46 Neck swelling 84

Discrete swellings in the neck 85

Cervical lymphadenopathy 85

Unexplained lymphadenopathy 85

Diffuse swelling of the neck 85

47 Neck swelling: Cervical lymphadenopathy in generalized lymphadenopathy 86

Systemic infections 87

Inflammatory disorders (not known to be infective) 87

Neoplastic causes 87

Drugs 87

Others 87

48 Neurological conditions: Bell palsy, and trigeminal sensory loss 88

Bell palsy 89

Trigeminal sensory loss 89

49 Neurological conditions and pain: Local, referred and vascular 90

Local causes of orofacial pain 90

Referred causes of orofacial pain 91

Vascular causes of orofacial pain 91

50 Neurological conditions and pain: Trigeminal neuralgia 92

Trigeminal neuralgia 93

51 Neurological conditions and pain: Psychogenic (idiopathic facial pain, idiopathic odontalgia and burning mouth syndrome (oral dysesthesia)) 94

Persistent idiopathic, or unexplained (atypical) facial pain (IFP) 95

Burning mouth “syndrome” (BMS, glossopyrosis, glossodynia, oral dysesthesia, scalded mouth syndrome, or stomatodynia) 95

52 Jaw conditions: Temporomandibular pain-dysfunction 96

Temporomandibular joint pain-dysfunction syndrome (TMPD), myofascial pain dysfunction (MFD), facial arthromyalgia (FAM), mandibular dysfunction, or mandibular stress syndrome 97

53 Jaw bone conditions: Radiolucencies and radiopacities 98

Radiolucencies 98

Radiopacities 99

Mixed radiolucent and radiopaque lesions 99

54 Jaw bone conditions: Odontogenic diseases and cysts 100

Odontogenic infections 101

Odontogenic cysts 101

55 Jaw bone conditions: Odontogenic tumors 102

Benign odontogenic tumors 102

Malignant odontogenic tumors 103

56 Jaw conditions: Bone disorders 104

Non-neoplastic diseases 105

Neoplastic disorders 105

57 Jaw bone conditions: Fibro-osseous lesions 106

Osseous dysplasia, cemento-osseous dysplasia (COD), periapical cemental or cemento-osseous dysplasia (PCD) 107

Cherubism 107

Fibrous dysplasia 107

Hypercementosis 107

Ossifying fibroma (cemento-ossifying fibroma) 107

Paget disease of bone 107

58 Maxillary sinus conditions 108

Rhinosinusitis (sinusitis) 109

Neoplasms 109

59 Oral malodor 110

60 Human immunodeficiency virus (HIV) infection and AIDS 112

Index 115

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