Dental OSCE (Objective Structured Clinical Examination) Practice Exam

If a white lesion appears exophytic with a narrow base and the patient frequently plays with it, what is it likely to be?

1. Fibroma

2. Keratoacanthoma

3. Papilloma

4. Squamous cell carcinoma

The correct answer is: Papilloma

A white lesion that is exophytic, meaning it projects outward from the surface, and has a narrow base can indicate a papilloma. This type of lesion is typically characterized by finger-like projections, which can often lead to a rough or warty appearance. The fact that the patient frequently manipulates it could be indicative of a benign nature, as benign lesions are often noticed and played with more by patients due to their physical characteristics and discomfort they may cause. Papillomas are generally caused by viral infections, specifically human papillomavirus (HPV), and are commonly found in the oral cavity. They are usually painless and may be mistaken for other types of lesions that also appear white and exophytic. Considering their growth patterns and typical behavior, papillomas do not typically have aggressive features that are associated with malignant conditions. In contrast, conditions like keratoacanthoma and squamous cell carcinoma tend to exhibit more concerning attributes such as faster growth, ulceration, and induration, which would often lead a patient to seek treatment rather than play with the lesion. A fibroma, while also exophytic and potentially appearing white, typically has a wider base and does not present the same prominent projections as a papilloma. Therefore, in the