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Keeling Spring Textbook > 1. Desquamative Gingivitis > Flashcards

1. Desquamative Gingivitis Flashcards

1
Q

What is desquamative gingivitis

A

A clinical term for red/ ulcerated gingiva

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2
Q

What are the types of immunoflouresence, and how do they differ

A

Direct and indirect. Direct is applied directly to the tissue, indirect utilizes an animal serum for example monkey

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3
Q

How do you fix biopsy samples

A

Formalin 10% for H and E, Michels 7% for immuno

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4
Q

What is OLP

A

Inflammatory muco cutaneous disease of mucosal surfaces

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5
Q

Who gets OLP

A

2:1 F:M, middle aged women

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6
Q

What are the types of OLP

A

Reticluar, erosive and vesicular

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7
Q

Where is OLP commonly located

A

Lateral Tongue, Buccal Mucosa, Gingiva, Palate

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8
Q

What is pathology of OLP

What infiltrates where

A

Sub epithelial infiltration of T Cells,

Basal cell liquefaction, saw tooth rete pegs, Civatte bodies

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9
Q

What is the immunoflouoresence of OLP

A

C3 and IgM

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10
Q

What is the malignant potential of OLP

A

2%

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11
Q

What is the treatment of OLP

A

Oral rinse: Lidex

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12
Q

How do you take a biopsy

A

Normal and abnormal tissue. Abnormal tissue will show disease, but normal tissue will also show the disease in Pemphigus and Pemphigoid

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13
Q

What is Pemphigoid

A

Immune mediated sub epithelial bullae

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14
Q

Who develops Pemphigoid

A

Its uncommon, Ladies over 50

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15
Q

What are the subtypes of Pemphigoid

A

Bullous, Mucous Membrane, Citatricial

Black Minesweepers Meditated Cockily

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16
Q

Which type of Pemphigoid affects the eyes and genitals

A

Mucous Membrane

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17
Q

Where does Pemphgoid occur intra orally

A

Gingiva or soft palate

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18
Q

What is the clinical appearance of Pemphigoid

A

Tense Bullae or Desquam gingivitis. Bullae last several days.

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19
Q

What is the pathologic appearance of Pemphigoid - What do you see down the mircoscope… Don’t forget immunoflouoresence…

A

Sub epithelial vesicles, linear IgG and C3 at basemenr membrane

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20
Q

What is the positive rate of immunoflouoresence in Pemphigoid

A

90% positive

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21
Q

What is the treatment for Pemphigoid

There are 3…

A

Lidex, Clobetasol 0.5%, or biologics if refractory

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22
Q

What is pemphigus

A

An autoimmune bullous disorder

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23
Q

Who gets pemphigus

A

M=F, 40 - 60 yo, Ethnic Groups

Serious
Both of us

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24
Q

What are the 4 subtypes of pemphigus

A

Vulgaris, foliaceous, vegitans and paraneoplastic

Victor flogged velvet Perseus

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25
What is the clinical presentation of pemphigus | What sign is clinically important
Rarely see bullae, usually ulcers/ blisters, large and painful. Positive Nikolsky sign
26
What is the pathology of pemphigus What do you see down the microscope
Intra epithelial bullae Acantholysis Tzanck Cells
27
What is the immunoflouresence of pemphigus You know this...
Chicken Wire appearance, IgG and C3
28
What is the trt of pemphigus
Systemic steroids.. Prednisolone 150-360 mg daily for 6-8/52
29
What is chronic ulcerative stomatitis
Chronic ulcerative stomatitis (CUS) is an immune‐mediated disorder characterized by oral erosions and ulcers usually refractory to conventional treatments. The disease often involves middle‐aged and older women with painful lesions. Sometimes resembling those of erosive oral lichen planus.
30
Who gets chronic ulcerative stomatitis
Women in their 40's
31
What are the clinical signs of chronic ulcerative stomatitis what do you see when you look in their mouth
Small blisters and erosions
32
Where are the lesions of chronic ulcerative stomatitis found
Gingiva and lateral border of the tongue
33
What is the pathology of chronic ulcerative stomatitis What do you see down the microscope
hyperkeratosis, acantholysis, liquefaction of basal cell layer
34
What is the immunoflouoresence of chronic ulcerative stomatitis It is speckled
Speckled IgG
35
What is the treatment of chronic ulcerative stomatitis
Mild- topical steroids
36
What is Linear IgA Disease
An uncommon muco cutaneous disease
37
Who develops Linear IgA Disease
Middle aged ppl
38
What are the clinical signs of Linear IgA Disease Its a real mouthful
Pruritic vesiculo bullous rash, plaques annular manifestation
39
Where does Linear IgA Disease occur
Anywhere on the body Scars Mucous membranes
40
What is the pathology of Linear IgA Disease
Subepidermal blisters with neutrophilic infiltration Identical to dermatitis herpetisformis Immune mediated maybe
41
What is the immunofluoresence of Linear IgA Disease
IgA - duh
42
What is the treatment of Linear IgA Disease
Sulfones and Dapsone. IgA - d A psone
43
What is dermatitis herpetiformis
Dermatitis herpetiformis (DH) is a rare, chronic, autoimmune skin condition, seen in young adults. It is characterized by the presence of groups of severely itchy blisters and raised red skin lesions. These are most commonly located on the elbows, knees, buttocks, lower back and scalp.
44
What systemic autoimmune disease is associated with Dermatitis Herpetiformis
Celiac Disease - 25% of pts have this
45
What are the clinical symptoms of Dermatitis Herpetiformis
Bilateral symmetrical pruritic papules, extensor surfaces of extremities, cluster vesicles
46
What is the pathology of Dermatitis Herpetiformis
Focal aggregation of neutrophils, fibrin deposits at dermal pegs
47
What is the immunofluoresence of Dermatitis Herpetiformis
IgG and C3
48
What is the treatment for Dermatitis Herpetiformis
Gluten free diet, dapsone
49
What is Lupus
An autoimmune disease
50
What are the signs of lupus extra orally
Malar butterfly rash
51
What are the intra oral signs of Lupus
Hyperkeratotic Plaque
52
What is the pathology of Lupus What do you see down the microscope
Anti Nuclear Antibodies. C3 at dermal/ epidermal junction.
53
What is the treatment of Lupus
Topical steroids, systemic steroids
54
What is Erythema Multiforme
Immune complex vasculitis. Classified as Minor or Major. Acute bullous and macular inflammatory muco cutaneous disease.
55
Who develops Erythema Multiforme
20 - 40 year old. Frequently associated with drugs
56
What is associated with development of Erythema Multiforme
Herpes and Drugs.. A lot of drugs!
57
What are the clinical signs of Erythema Multiforme
Multiple large painful ulcers 70% of pts have oral lesions. Target Lesions.
58
What is the pathology of Erythema Multiforme
Liquefaction of the upper epithelium Intra epithelial microvesicles No acantholysis
59
What is the immunofluoresence of Erythema Multiforme Think about it - Or maybe don't!!
None
60
What is the treatment of Erythema Multiforme
Topical anti histamines, topical anaesthetics
61
How do you assess for drug related reactions What filling materials may be implicated
Multi form. Contact allergy. Biopsy and patch test. Replace amalgam.
62
What are the key issues to know according to Dr Villareal
OLP, Pemphigus, Pemphgoid. Table 26.1 about the immunof of everything and what the immunof looks like
63
What are the differences between apthous ulcers and herpetic lesions
Apthous: Movable mucosa, do not coalesce Herpetiform: Bound keratinized tissue, coalesce
64
How do you treat herpetic lesions
5% acyclovir Lesions self limiting, last 7 - 14 days.

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