Exam 5-NON-Infective stomatits PART 2 Flashcards
What is described as having an acute onset, immune mediated blistering mucocutaneous condition?
Erythemia Multiforme
Erythema multiforme is NOT ________ but it is immune related
auto-immune
Erythema Multiforme is most often following _________ or often as a post infectious process, esp post _____.
systemic medications….VIRAL
Erythema Multiforme is self limiting and typlically clears in HOW LONG?
2-6 weeks
Erythema Multiforme affects skin and mucous membranes, rarely ONLY in the _______
mouth
What age range is typically affected by Erythema Multiforme? Is there a sex preference?
young adults in their 20s-30s and MALES affected more
Which virus is typically to blame for Erythema Multiforme?
Herpes simplex
Fever, malaise, headache, cough, sore throat are all ______ symptoms of Erythema Multiforme
prodromal
What is the recurrence rate of Erythema Multiforme?
20%
What is the most classic condition for manifestations of disease on PALMS and SOLES? What are two other possibilites?
The classic: erythema multiforme…..the other two-secondary syphilis and coxsackie A (hand-foot-mouth disease)
The condition is called MULTIFORM because the skin lesions are highly ______
variable
What are the two descriptors for the lesions of Erythema Multiforme?
TARGET or BULL’S EYE
Can Erythema Multiforme appear WITHOUT oral lesions?
YEP!
Erythema Multiforme: Oral ulcers with erythema and _______ borders
irregular
Holy S…the locations for Erythema Multiforme are labial mucosa, tongue, floor of mouth, soft palate and MOST COMMONLY ______ with crusting and bleeding at the ________
the LIPS with bleeding at the VERMILLON zone
What is the MOST SEVERE form of Erythema Multiforme?
Steven-Johnson Syndrome
Which condition shows extensive mucosal ulceration that also affects genital and OCULAR mucosa?
Steven-Johnson Syndrome
What is the usual trigger of Steven-Johnson Syndrome?
medications
Which complication of Steven-Johnson Syndrome makes it life threatening?
it can affect internal organs
WHAT IS THE MOST SEVERE FORM of Steven-Johnson syndrome?
TEN-Toxic Epidermal Necrolysis
What is the trigger for the MOST SEVERE form of Erythema Multiforme?
Toxic Epidermal Necro-Lysis is triggered by DRUG exposure
TEN-Toxic EpiDermal NecroLysis is shows diffuse sloughing of skin and mucosal surfaces and has a predilection for WHICH SEX?
FEMALE
After identifying the source of Erythema Multiforme, what is the treatment?
topical and SYSTEMIC high dose steriods (60mg prednisone)
What are the two other (probably more offical) names for Geographic Tongue?
Erythema migrans and benign migratory glossitis
Geographic tongue is an inflammatory tongue condition of WHAT TYPE OF ETIOLOGY?….its also relatively common (__-___% of population)
1-3% of the population
Since we all know geographic tongue is more common in women than men, HOW much is it more common??
2x
Geographic tongue rrimarily affects ______ and _____ borders of tongue
dorsal and lateral
In geographic tongue depapillated areas that are erythematous or normal colored with characteristic WHAT 2 COLORED?? borders that marginate the lesions.
yellow-white
GOOD TO KNOW: geographic tongue heals spontaneously and recur at different sites…its usually asymptomatic but occasional _______
BURNING
What patients can see an increased incidence of Geographic tongue?
Psoriatic patients
What is the treatment for geographic tongue?
no Tx necessary, but TOPICAL steroids if symptomatic
What is a rare syndrome in which the oral lesions LOOK like geographic tongue and also comes with urethritis, arthritis, conjunctivitis?
REI_TERS Syndrome
What is an autoimmune disease that is 8x more common in women and the average age is 31??
LUPUS ErythemaTOsus
Lupus Erythematosus is an _________ disease that is _x more common in women and the average age is ___
autoimmune..8x…31
What is the classic skin lesion of Lupus Erythematosis and what % of patients show this sign?
the BUTTERFLY rash and 50-80% show it
What form of lupus has the condition that lesions are confined to skin?
Discoid LE
Discoud LE: ___% have ORAL lesions: erythematous plaques or erosions with WHAT COLOR striations??
25%…white (like Lichen Planus)
Systemic LE is chronic and progressive, can be LIFE-THREATENING and affect multiple organs including _____, ______, and ______
CNS, Heart, Kidney
Which form of lupus has periods of remission and disease inactivity?
Systemic LE
Lab tests for Lupus Erythematosus include ANA (_________) & antibodies to the patient’s own DNA
antinuclear antibodies
________, anti-malarial drugs (__________), and other immunosuppressive medications are used in systemic LE
Corticosteroids, anti-malarial drugs (hydroxychloroquine),
_______ are given for symptomatic treatment of SLE and _______ drugs for more SEVERE conditions
NSAIDS…..Antimalarial
What is a RARE immune mediated DEPOSITION of collagen in skin and other tissues?
Scleroderma (systemic sclerosis)
Systemic sclerosis / scleroderma is usualy 3:1 favoring WHICH sex?
women
Which condition is associated with Raynaud’s phenomenon?
Systemic Sclerosis/Scleroderma
_______ phenomenon: vasoconstrictive event in extremities triggered by stress, cold.
RAY-naud’s
Raynaud’s phenomenon: vaso________ event in extremities triggered by ______, ____.
constrictive…stress, cold
What is the disease when a scleroderma causes the skin to be diffuse, hard, and taut?
“Hide bound disease”
Oral manifestations of Scleroderma: WTF is _______??? its found in 70%, dysphagia, ± xerostomia
Microstomia
Oral manifestations of Scleroderma: diffuse ________ of PDL
WIDENING (the collagen is GROWING)
DANG-Oral manifestations of Scleroderma: resorption of _____ or ______ or _______
RAMUS or CONDYLE or CORONOID
SCLERODERMA affects other _______ and can lead to _______
organ…organ failure
Diagnosis of Scelroderma: Clinical features and ______ 70 antibodies (_________ 1)
Anti-Scl (Topoisomerase 1)
What are the two meds used to treat scleroderma?
D-Penicillamine and Ca Channel Blockers
What does the prognosis of Scelroderma depend on??
depends on organ involvement
Graft Vs Host Disease (GVHD) is an immune reaction following WHAT TYPE of bone marrow transplantation.
ALLOGENIC (from another donor)
How much time divides chronic vs acute GVHD?
1st 100 days = acute….after that CHRONIC
In GVHD the oral lesions appear ________ and PAINFUL
lichenoid
What are the two types of drugs used to treat GVHD?
immunosuppresive meds and corticosteroids
What is the patient at risk for when going through GVHD?
dysplasia and Oral Cancer
