Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ DISEASES OF THE LIPS ICD-10: K13.0 + +++ ANGULAR CHEILITIS (PERLÈCHE) ++ Associated with increased moisture at commissures, salivation (at sleep). Predisposing factors: Thumb sucking in children; sagging face and loss of teeth in older persons; candidiasis in immunocompromised persons; Staphylococcus aureus in atopic dermatitis and isotretinoin treatment. Findings: Erythema and maceration at commissures (see Fig. 33-1). Diagnosis: KOH for candidiasis; culture for S. aureus, Candida. Management: Identify and treat causes. ++ Figure 33-1 Angular cheilitis Mild erythema and scaling in bilateral commissures. (Used with permission from Dr. Nathaniel Treister.) Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ ACTINIC CHEILITIS ++ Actinic/solar keratoses, usually of the lower lip. Rule out squamous cell carcinoma in situ (SCCIS) or invasive if papule or nodule or ulcer occurs (see Section 11). +++ CONDITIONS OF THE TONGUE, PALATE, AND MANDIBLE ICD-10: K14 + +++ FISSURED TONGUE ++ Normal variant in up to 11% of population. Asymptomatic. Findings: Multiple folds with anterior-posterior orientation on the dorsal surface of the tongue (Fig. 33-2). Associated disorders: Psoriasis, Down syndrome, acromegaly, and Sjögren syndrome. Synonyms: Lingua fissurata, lingua plicata, scrotal tongue, grooved tongue, furrowed tongue. ++ Figure 33-2 Fissured tongue Deep furrows on the dorsum of the tongue are asymptomatic. Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ BLACK OR WHITE HAIRY TONGUE ++ Pathogenesis: Defective desquamation of filiform papillae resulting in hair-like projections on the dorsum of the tongue. Associations: Heavy tobacco use, mouth breathing, systemic antibiotic therapy, poor oral hygiene, general debilitation, radiation therapy, chronic use of bismuth-containing antacids, or lack of dietary roughage. Findings: Furry plaques on dorsal tongue (Fig. 33-3). Candidiasis may occur secondarily. Management: Eliminate predisposing factors; good oral hygiene. Synonym: Lingua villosa (nigra). ++ Figure 33-3 (A) Hairy tongue Defective desquamation of filiform papilla noted in posterior aspect of tongue. Tongue has a white surface caused by retained keratin. (Used with permission from Dr. Nathaniel Treister.) (B) Black hairy tongue In this example, chrormogenic bacteria have stained the tongue black. Graphic Jump LocationView Full Size||Download Slide (.ppt) +++ ORAL HAIRY LEUKOPLAKIA ++ Pathogenesis: Epstein–Barr virus infection; low CD4 cell counts (See Section 27). Findings: White corrugated plaques on lateral aspects of tongue (see Fig. 27-66). Does not occur in successfully treated HIV/AIDS. +++ MIGRATORY GLOSSITIS ICD-10: K14.1 ++ Irregular areas of dekeratinized and desquamated filiform papillae (red in color) are surrounded by elevated whitish or yellow margins (Fig. 33-4). Etiology: Unknown; possible link with psoriasis. Incidence: Common; usually asymptomatic. Synonym: Geographic tongue. +... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.