Lesi

 

• Definisi

  • An area of abnormal tissues

  • Any damage or abnormal change in the tissue of an organism

  • Caused by trauma

  • Latin : laesio mean injury

  • No specialised classification of lesion

  • Naming by their pattern, size, location or causes

  • Med :

    a region in an organ or tissue which has suffered damage through injury or disease

  • wound, ulcer, abscess, or tumour

• Oral lesion :

  • Injury that occurs on the mucous membrane of the oral cavity
  • Very common
  • Occurring in association with many disease by many different mechanism

• Oral lesion

  • Causative agent
  • Colorisation
  • Shape
  • Size
  • Systemic
  • Localised
  • Malignant Premalignant

• Classification

  • Metabollic/ systemic
    • Hormonal
    • Nutritional
  • Inflammatory
    • Trauma
    • Infective
      • Bacterial
      • Fungal
      • Viral
    • Reactive
    • Immunologic
      • Hypersensitivity
        • Exogenous allergen
        • Endogenous allergen (autoimmune)
  • Neoplasia
    • malignant
    • premalignant
    • benign
  • Developmental
    • genetic (heritable)
    • acquired

• Clinical classification of oral mucosal lesion

  • white
  • red
  • pigmented
    • brown
    • blue
    • black
  • ulcerative
  • vesiculobullous
  • swelling
    • smooth surface
    • papillary, popular, and multiple polupoid

• General direction of growth of lesion

  • Exophytic

    ke arah luar

    secara vertikal

  • Endophytic

    ke arah dalam (cekung)

• Secara umum tebagi menjadi :

  • Lesi primer

    lesi pertama yang muncul dari keadaan normal

    • bisa berkembang atau tidak

  • Lesi sekunder

    • berasal dari lesi primer
    • misal: di rongga mulut→ exophytic jadi endophytic

• Struktur

  epitel:

  korneum

  lucidum

  granulosum

  connective propria

  otot

  PD dan saraf

  lemak

  keringat

  

Lesi Primer

• Macule

  • Circumscribed
  • Flat lesion less than 1 cm in size
  • Varied in shape and color
  • May represent hyper pigmented,hypopigmented, vascular abnormalities

• Patch/ Bercak

  • Circumscribed
  • Flat lesion larger than 1 cm in size
  • Varied in shape and color
  • May represent hyper pigmented, hypopigmented, or vascular abnormalities

  

• Papule

  • Circumscribed
  • Elevated
  • Superficial
  • Solid lesion less than 1cm in size
  • varied in shape and color

  

• Plaque

  • Circumscribed
  • Elevated
  • Superficial
  • Solid lesion larger than 1 cm in size
  • varied in shape and color
  • Form by a confluence of papule

• Nodule

  • Solid palpable lesion
  • Less than 1 cm in size
  • No fluid inside
  • Depth may be above,above, level with, or beneath mucosal surface
  • Result of inflammatory, neoplastic, metabolic prosecces
  • Soft, firm, hard (bony), fixed, movable
  • Pedunculate (stem-like connecting part)
  • Sessile (attached by base)

  

• Tumor

  • Solid palpable
  • Larger than 1 cm in size
  • No fluid inside
  • Depth may be above,above, level with, or beneath mucosal surface
  • Result of inflammatory, neoplastic, metabolic prosecces
  • Soft, firm, hard (bony), fixed, movable
  • Pedunculate (stem-like connecting part)
  • Sessile (attached by base)

• Wheal

  • Oedematous, rounded or oval transitory papule
  • Variable in size
  • Usually result of an allergic reaction

• Vesicle

  • Circumscribed elevated intraepithelial lesion
  • Sub epithelial lesion
  • Less than 1 cm in size
  • Contain serous fluid

  

• Bulla

  • Circumscribed
  • Elevated intraepithelial or sub epithelial lesion
  • Larger than 1 cm in size
  • Contain serous fluids

• Cyst

  • Encapsulated lesion
  • Variable size in subcutaneous or submucosal tissue
  • Filled with liquid or semisolid material

  

• Pustule

  • Circumscribed
  • Elevation of variable size and shape
  • Containing purulent exudates
  • White, yellow, or greenis-yellow

• Hemangioma

  • Red irregular macule or patch
  • Variable size and shape
  • Cause by dilation of dermal or mucosal capillaries

  

Lesi Sekunder

• Hematoma

  • Accumulated mass of extravasated blood
  • Clots to form solid swelling
  • Variable in size and shape

  

• Scale

  • Abnormal shedding (desquamating)→lepas
  • Dry and flaky
  • Dead epithelial cell

  

• Athropy

  • Diminution in the size of cells, tissues, organ or body parts

  

• Erosion

  • Gradual breakdown of epithelium
  • Heal without scarring
  • Do not extend through epithelium
  • Called abrasion

  

• Ulcer

  putih kekuningan bulat tegas haloeritema

  • Depressed lesion
  • Extend through epithelium into the dermis
  • Excavation of epithelium extend below basal cell layer
  • May heal with scar

  

  putih2=benang fibrinogen

• Fissure

  • Linear crack or cleavage in epithelial tissue
  • Sharply defined abrupt walls

  

• Crust/ Krista

  • Hardened deposit of variable thickness
  • Consisting of dried blood, serum or purulent exudate

  

• Scar

  • Mark that remain after healing of wound
  • Atrophic or hypertrophic
  • Consequence of variable degrees of collagen proliferation

  

• Sinus

  • An abnormal channel
  • Leads from pathological space to an anatomical space
  • Permitting escape of pus