Developmental And Immune Mediated Mucocutaneous Conditions Flashcards
What are the 2 other names of Erythema Migrans?
Geographic tongue, Benign Migratory Glossitis
What causes erythema migrans and how common is it?
Probably immune mediated, 1-3 % of the population
What is the erythema of erythema migrans caused by?
Atrophy of filiform papillae and shearing of parakeratin.
What is it called when you have geographic tongue somewhere other than the dorsal aspect of the tongue?
Ectopic erythema migrans
Treatment for geographic tongue
None needed, occasionally if painful with foods can be treated with potent topical steroids.
Which type of lichen planus resolves after 7-10 years?
Cutaneous, mucosal is more chronic.
Wickham’s striae and purple polygonal pruritic papules are clinical features of which immune mediated condition?
Lichen Planus
What are the two oral forms of lichen planus?
Reticular (lacy white lines) and erosive (erythematous, may ulcerate)
Clinical features of Oral Lichen Planus
Reticular LP (white lines), ELP, bilateral buccal mucosa, tongue, gingiva common but any intraoral surface and lips.
Oral lichen planus has a malignant transformation. T/F
False, there is controversy over this, it is probably something else that turns malignant
What is the first thing to do if you find Oral Lichen planus?
Rule out candidiasis
How do you treat Erythematous Oral Lichen Planus
Potent Topical steroid “off Label”
What is it called when something appears to be lichen planus but is caused by something else?
lichenoid—amalgam reaction, drug reaction, mucositis etc
Most common collagen vascular/connective tissue disease in U.S.
Lupus erythematosus
what are the 3 forms of Lupus Erythematous
Chronic Cutaneous Lupus Erythematous, Systemic Lupus Erythematosus, Subacute cutaneous lupus erythematosus
Clinical Features of Chronic Cutaneous Lupus Erythematosus
Skin-scaly erythematous patches, heal then reappear, scars. Lichenoid mucositis
Malar “butterfly rash” is associated with?
Systemic Lupus Erythematosus
What are the 2 involvements you should be worries about with systemic lupus?
Renal and cardiac involvement
Rare condition characterized by inappropriate deposition of dense collagen
Systemic Sclerosis
Hard smooth texture of skin, raynaud phenomenon, sclerodactyly, acro-osteolysis, mask like face, atrophy of alae, mouse facies, dysphagia are all clinical features of what?
Systemic Sclerosis
Discoloration of the fingers or toes after exposure to changes in temperature or emotion events
Raynaud’s phenomenon
resorption of posterior ramus, diffuse widening of PDL and possibly root resorption are radiographic features of what?
Systemic sclerosis
Most deaths of systemic sclerosis are due to what?
deposition of collagen on internal organs
Systemic sclerosis prognosis, limited cutaneous involvement is better/worse than diffuse cutaneous involvement
Better
What does CREST syndrome stand for?
Calcinosis cutis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasia-These are a milder version of systemic sclerosis
Is CREST syndrome better or worse than systemic sclerosis?
Better than sclerosis
Group of inherited disorders in which two or more ectodermally derived structures do not develop normally or fail to develop
Ectodermal dysplasia
Hypohidrotic ectodermal dysplasia is what?
Heat intolerance in ectodermal dysplasia-I’m not actually sure.
In what disease do autoantibodies destroy desmosomes?
Pemphigus vulgaris
Pemphigus Vulgaris has (oral or body) lesions that are “first to show, last to go”?
Oral
What is a nikolsky sign and what does it indicate?
Inducing a bulla by applying firm lateral pressure on skin, indicates Pemphigus Vulgaris
which immunofluorescence is used to detect antibodies in tissues?
direct
which immunofluorescence is used to detect antibodies in blood?
indirect
treatment for pemphigus vulgaris
systemic corticosteroids
prognosis of pemphigus vulgaris
prior to therapy, 60-90% mortality, 5-10% after treatment
mucous membrane pemphigoid more or less common than pv
more, 2x
would you see intraoral intact blisters in mucous membrane pemphigoid or pemphigus vulgaris?
MMP
Clinical features of Mucous Membrane pemphigoid
desquamative gingivitis
Scarring involvement of the symblepheron in the eye is the most significant aspect of which condition?
Mucous Membrane Pemphigoid
Mucous Membrane Pemphigoid is positive or negative DIF and IIF?
Positive DIF and Negative IIF
Treatment for Mucous membrane Pemphigoid
Topical steroids-frequent dental prophylaxis and refer to opthalmologist
Prognosis for Mucous Membrane Pemphigoid
Rarely fatal, blindness can result
What is the most common of autoimmune blistering conditions?
Bullous Pemphigoid
Bullous Pemphigoid is positive or negative IIF and DIF
Positive to both
Treatment for Bullous Pemphigoid
Usually resolves within 2 years
Acute onset of ulcerative disorder skin and mucous membranes
Erythema Multiforme
When is erythema multiforme considered major?
2 or more mucosal sites in conjunction with skin lesions
Stevens-JOhnson syndrome
at least 2 mucosal sites plus skin involvement (<10%)
Toxic epidermal necrolysis
Diffuse bullous involvement of skin and mucosa (>30%)
Stevens-Johnson syndrome and Toxic epidermal necrolysis are almost always triggered by what?
a Drug
Treatment for EM
Discontinue the problem drug, steroids, analgesics
What should be avoided in management of Toxic Epidermal Necrolysis?
Steroids
