Chapter 9

Question 1

What is a common oral lesion that are clinical alterations that involve variable fungiform papilla that likely represents a hypersensitivity or allergy? There are three patterns of this (Localized, Generalized and Diffuse), what makes these different?

Answer 1

1. Transient Lingual Papillitis
2. Localized:
   - One to several fungiform papilla involved, they become enlarged and are red or yellow, anterior dorsal tongue and painful.
   Generalized:
   - A large percentage of fungiform papilla involved, they become enlarged and red, tip & lateral dorsal tongue, very sensitive/painful, associated with fever & lymphadenopathy, and can spread among family members.
   Diffuse:
   - Large number of affected papilla, appear as elevated, yellow or white papule, and asymptomatic.

Question 2

What has no universal etiology; seems to be an allergy or immune dysfunction of some sort, and exclusively occur on movable mucosa? There are major, minor and herpetiform forms of this, what makes them different?

Answer 2

1. Recurrent Aphthous Ulcerations (RAU)
   AKA: Recurrent aphthous stomatitis (and canker sores)
2. RAU – Minor: Occurs in children, larger lesions, no scarring, fewest lesions/episode and fewest recurrences.
   RAU - Major: Occurs in adolescence, quickest to heal, possibility of scarring, middle amount of lesions/episode and recurrences. (Also called Sutton’s Disease)
   RAU - herpetiform: Occurs in adults, no scarring, most lesions/episode and most recurrences.

Question 3

What is chronic, recurrent immune mediated disease with oral aphthous-like ulcerations, ocular inflammation, genital ulcers and skin lesions where joint pain is common complaint?

Answer 3

Behcet’s syndrome

Question 4

What is a multi-system granulomatous disorder of unknown cause, which is more common in african americans, 90% will show abnormal chest XRAY, involves lymphoid tissues and skin lesions in most cases, and has elevated serum angiotensin? What two syndromes are associated with this? What do these look like histologically (4 things)?

Answer 4

1. Sarcoidosis
2. Lofgren’s syndrome and Heerfordt’s syndrome (uveoparotid fever).
3. • Granulomatous inflammation
   • Schaumann bodies (degenerated lysosomes)
   • Asteroid bodies (entrapped collagen fragments)
   • Hamazaki-Wesenberg bodies (large lysosomes)

Question 5

What involves erythema nodosum, bilateral hilar lymphadenopathy, arthralgia and are associated with Sarcoidosis?

Answer 5

Lofgren’s syndrome

Question 6

What involves parotid enlargement, inflammation of eye, facial paralysis, fever and are associated with Sarcoidosis?

Answer 6

Heerfordt’s syndrome

Question 7

What is a condition characterized by persistent enlargement of the soft tissues of the mouth, mostly the lips, usually the enlargement does not cause any pain? What is this called when only the lips are involved? What syndrome is associated with this and fissured tongue? Histologically what does it look like?

Answer 7

1. Orofacial Granulomatosis
2. Cheilitis granulomatosa
3. Melkersson-Rosenthal syndrome
4. Granulomatous inflammation

Question 8

What is necrotizing granulomatous lesions of respiratory tract, necrotizing glomerulonephritis, and systemic vasculitis of small arteries and veins? When it affects the upper respiratory system and no renal lesions what is it? When it affects the skin & mucosa? What is the early manifestations of this that affects the gingiva, demonstrate a florid, erythematous, granular hyperplasia? What is the diagnosis for this?

Answer 8

1. Wegener’s Granulomatosis
2. Limited Wegener’s granulomatosis
3. Superficial Wegener’s granulomatosis
4. Strawberry gingivitis
5. Presence of antineutrophil cytoplasm antibodies (ANCA) [Can be Perinuclear (p-ANCA) or Cytoplasmic (c-ANCA)]

Question 9

What are reactions that are most common with products associated with prolonged/frequent contact of cinnamon, gingiva can appear swollen and red, and sloughing off may occur?

Answer 9

Contact Stomatitis

Question 10

What is diffuse edematous swelling of the soft tissues, no pain, but itching and erythema can be present, and most common cause is mast cell degranulation, more common in african americans and which leads to histamine release (IgE)? This is also called what? What usually causes this?

Answer 10

1. Angioedema
2. Quince’s disease
3. Caused by angiotensin-converting enzyme (ACE) inhibitors, such as Lisinopril.