9 Allergies/Immune Diseases

Question 1

What is the diagnosis and variant of that?

Answer 1

Transient Lingual Papillitis - Generalized

Question 2

What is the full diagnosis?

Answer 2

transient lingual papillitis - localized

Question 3

Is this generalized or papulokeratotic variant of transient lingual papillitis?

Answer 3

Papulokeratotic (aka diffuse) because the inflamed papillae have excess keratin deposited on top of them

Question 4

This is on movable mucosa and is painful. What will you tell your patient?

Answer 4

Recurrent aphthous ulcer

(aka aphthous stomatitis)

Question 5

If this RAU is less than 1cm across and is seen on a young patient, describe how it will heal.

Answer 5

(Minor RAU) Will heal without scarring in 7-14 days

Question 6

Seen in an adolescent. How long does it take to heal? Does it scar? Where else could you find these?

Answer 6

1. 2-6 weeks to heal
2. possibility of scarring
3. can be found on labial mucosa, soft palate, or tonsillar fauces

Question 7

This lesion is 1.5cm in diameter. What are two names for this?

Answer 7

1. Major Recurrent Aphthous Ulcer
2. Sutton’s Disease

Question 8

If this isn’t herpes, what else could it be?

Answer 8

Herpetiform RAU

Question 9

If these are RAUs, what kind is it? How old is the patient? How long does it take to heal?

Answer 9

1. Herpetiform (1-3mm across)
2. adult patient
3. 7-10 days w/o scarring

Question 10

Pt presents with aphthous-like lesions in mouth, genital ulcers, and erythema nodosum-like lesions. What could this be?

Answer 10

Behçet’s Syndrome

Question 11

What are some common presentations of Behçet’s syndrome?

Answer 11

Aphthous-like ulcers (99%)

Genital ulcers (75%)

Ocular inflammation (70-85%)

Joint pain is common

Question 12

What nationalities are typical to see Behçet’s syndrome?

Answer 12

Turkish, Japanese, Eastern Mediterranean

Question 13

What organs are usually affected by sarcoidosis?

Answer 13

lungs, lymph nodes, skin, eyes, salivary glands

Question 14

What two types of skin lesions can manifest in sarcoidosis?

Answer 14

Lupus pernio (purple lesions on H&N specific to sarcoidosis)

Erythema nodosum (scattered, red lesions on lower legs non-specific to sarcoidosis)

Question 15

What are two syndromes associated with acute sarcoidosis?

Answer 15

1. Löfgren’s syndrome
2. Heerfodt syndrome

Question 16

To diagnose what pathology would you order this image?

Answer 16

sarcoidosis

Question 17

What are these chronic, purple, indurated lesions called? What pathology are they a manifestation of?

Answer 17

Lupus pernio - seen with Sarcoidosis

Question 18

With what syndrome associated with sarcoidosis is this manifestation?

Answer 18

Löfgren’s syndrome (picture showing erythema nodosum)

Question 19

Swelling of the face and lips is consistent with what?

Answer 19

Orofacial granulomatosis

Question 20

Swelling of just the lips is called?

Answer 20

Cheilitis granulomatosa

Question 21

What syndrome is associated with orofacial granulomatosis?

Answer 21

Melkersson-Rosenthal syndrome

Question 22

Strawberry gingivitis is seen with what pathology?

Answer 22

Wegener’s Granulomatosis

Question 23

Pt chews big red. What is this?

Answer 23

contact stomatitis (cinnamon related)

Question 24

diffuse edematous swelling of the soft tissues is what? (give both names)

Answer 24

Angioedema (aka Quinckie’s Disease)