Desquamative Gingivitis

Question 1

What is characterized with chronic desquamative gingivitis?

Answer 1

intense erythema, desquamation, ulceration of free and attached gingiva

Question 2

T/F: Chronic desquamative gingivitis always show symptoms.

Answer 2

False. They can be asymptomatic, mild burning to intense pain

Question 3

Where is chronic desquamative gingivitis usually located?

Answer 3

50% localized to gingiva but can also have intra or extra oral sites

Question 4

What is the genesis of chronic desquamative gingivitis?

Answer 4

Dermatologic Genesis

Question 5

What is the usual patient of a someone with chronic desquamative gingivitis?

Answer 5

40-50 year old female

Question 6

What can Lichen Planus affect?

Answer 6

oral cavity, genital tract, mucosa, skin, scalp, nails

Question 7

What cells play a major role in Lichen Planus?

Answer 7

T lymphocytes

Question 8

What is a possible etiology of Lichen Planus?

Answer 8

reaction to adjacent restoration

Question 9

How common is Lichen Planus?

Answer 9

0.1% to 4%

Question 10

What are the most common types of Lichen Planus?

Answer 10

Reticular and Erosive

Question 11

What is common in Reticular Lichen Planus?

Answer 11

• Wickham strae (white lines)
• bilateral
• asymptomatic

Question 12

What is common in Erosive Lichen Planus?

Answer 12

• Wickham strae (white lines)
• ulceration
• painful

Question 13

Compare/contrast reticular vs erosive Lichen Planus.

Answer 13

similar: both have Wickham strae (white lines)
difference: erosive is painful

Question 14

What is common in histopathology of Lichen Planus?

Answer 14

• T lymphocytes in lamina propria in abundance
• hydrophic degeneration
• colloid bodies at epithelium
• “saw tooth”

Question 15

What can you see with immunofluorescence in Lichen Planus?

Answer 15

fibrin and cytoid deposit

Question 16

What is the treatment of Lichen Planus?

Answer 16

asymptomatic= nothing
lesions= 0.05% flucinonide gel and clotrimazole 10 mg

Question 17

What is common in Pemphigoid?

Answer 17

cutaneous, separation between epithelium and connective tissue junction

Question 18

What’s the difference between bollous and cicatricial pemphigoid?

Answer 18

bollous= no scarring
cicatricial= scarring

Question 19

How common is pemphigoid in oral lesions?

Answer 19

40%

Question 20

What can you see in immunofluorescence in pemphigoid?

Answer 20

immunoglobulin G. complement 3, sometimes other immunoglobulins, fibrin deposits

Question 21

What is the treatment for pemphigoid?

Answer 21

corticosteroids (prednisone) and immunomodulator drugs

Question 22

Where can cicatrical/mucous membrane pemphigoid affect?

Answer 22

anywhere there is mucous a membrane

Question 23

What is symblepharon?

Answer 23

scarring resulting in adhesion between eyelid and eyeball seen in cicatrical/mucous membrane

Question 24

What is ankyloblepharon?

Answer 24

scarring resulting in adhesion at edges of eyelids

Question 25

How long is the cycle of pemphigoid oral lesion?

Answer 25

the bullae take 2-3 days to rupture after forming which then leave an ulceration healing takes 3 or more weeks

Question 26

What is the treatment of pemphigoid oral lesion?

Answer 26

0.05% fluocinonide gel and clobetasol propionate

Question 27

What is the difference in separation between pemphigoid and pemphigus vulgaris?

Answer 27

pemphigoid= separates between epithelium and connective tissue (sub epithelial) pemphigus vulgaris= separates between the 2 epithelial layers (intra epithelial) erythema multiform can be intra or sub epithelial

Question 28

What is etiology of pemphigus vulgaris?

Answer 28

- antibiotics and other drugs - autoantibody to cadherin-type epithelial cell adhesion molecules

Question 29

What is most often involved in the oral cavity for pemphigus vulgaris?

Answer 29

soft palate (80%) then buccal mucosa (46%) , then tongue (20%) , then lower labia mucosa (10%)

Question 30

What are key identifiers for pemphigus vulgaris?

Answer 30

- "tombstone" appearance in histopath - strawberry gingivitis - intra epithelial

Question 31

What do you give to treat chronic ulcerative stomatitis?

Answer 31

hydroxychloroquine because it's not responsive to corticosteroid treatment

Question 32

What are the clinical presentations of lupus erythematosis?

Answer 32

systemic, chronic, and cutaneous lesions are similar to lichen planus

Question 33

What is a key feature in erythema multiform?

Answer 33

target/iris lesion

Question 34

What is the later form of erythema multiform?

Answer 34

Stevens-Johnson syndrome which effects every mucosa of your body

Question 35

What is etiology of erythema multiform?

Answer 35

unknown but thought to be caused by cytotoxic immune reaction

Question 36

What is the histopathology of erythema multiform?

Answer 36

can be sub or intra epithelial

Question 37

What is the treatment of erythema multiform?

Answer 37

antihistamines, topical anesthetics (for pain), plaque control, systemic corticosteroids