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perio exam 2 > gingival lesions of systemic origin: Mucocutaneous disorders > Flashcards

gingival lesions of systemic origin: Mucocutaneous disorders Flashcards

1
Q

what is the most common mucocutaneous disease?

A

Lichen planus

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2
Q

what is the prevalence of lichen planus?

A

0.1-4%

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3
Q

Skin lesions of lichen planus are characterized by papules with white striae, known as ___________

A

(Wickham striae)

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4
Q

_______ is the most common symptom of lichen planus

A

itching

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5
Q

T/F: lichen planus skin lesions disappear after a few months but oral lesions stay for years

A

true

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6
Q

what are the common clinical characteristics of oral lichen planus?

A

white papules and white striation which often form reticular patterns, usually of bilateral occurrence.

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7
Q

what is a papule? a plaque? a bulla?

A

Papula= a small, inflammatory, congested spot on the skin; a pimple

Plaque= A patch on the skin or on a mucous surface

Bulla= A large blister or skin vesicle filled with fluid

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8
Q

what is meant when a lesion is described as “reticular”? what about “ulcerative”?

A

Reticular= Mesh; in the form of network

Ulcerative= Affected with an ulcer; open sore or lesion of the skin or mucosa accompanied by sloughing of inflamed necrotic tissue

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9
Q

what lichen planus lesion forms are associated with symptoms?

A

Atrophic, ulcerative, bullous forms

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10
Q

T/F: ular, reticular, plaque-like lesion forms are generally asymptomatic in Lichen plans

A

true

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11
Q

what are the microscopic characteristics of Oral Lichenoid Lesions?

A

is a subepithelial, band-like accumulation of lymphocytes and macrophages characteristic

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12
Q

what causes the accumulation of lymphocytes and macrophages in oral lichnoid lesions?

A

a type IV hypersensitivity reaction

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13
Q

what is the most important part of treating oral lichnoid lesions?

A

Most of important of part of the treatment is an atraumatic meticulous plaque control

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14
Q

T/F: Fibrin in the basement membrane, and deposits of IgM, C3, C4, and C5 are characteristic of OLP

A

true

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15
Q

what is a Pemphigoid?

A

A group of disorders in which autoantibodies migrate towards components of the basement membrane

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16
Q

what is the result of pemphigoid?

A

result in detachment of the epithelium from the connective tissue

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17
Q

Pemphigoid is characterized by autoantibody reactions against ________ and __________ components.

A

hemidesmosome and lamina lucida components.

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18
Q

what is benign mucous membrane pemphigoid (BMMP)?

A

a pemphigoid in which only mucous membrane are affected

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19
Q

Cicatricial pemphigoid is also used to describe subepithelial bullous disease limited to the ________ or _______

A

mouth or eyes

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20
Q

what is the main manifestation of BMMP?

A

desquamative lesions of the gingiva presenting intensely erythematous attached gingiva

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21
Q

which type of pemphigoid is associated with scarring?

A

cicatricial

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22
Q

name the 3 types of pemphigoids

A
  • Bullous
  • Benign Mucous Membrane
  • Cicatricial (Scar formation)
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23
Q

what is the “Nicholsky sign”? (related to pemphigoids)

A

Rubbing of the gingiva creates bulla formation

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24
Q

how is BMMP (and other pemphigoids) treated?

A

Plaque removal with daily use of chlorhexidine and/or topical corticosteroid

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25
Q

what are the lesions formed by Pemphigus vulgaris?

A

Formation of intraepithelial bullae in skin and mucous membranes

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26
Q

T/F: Pemphigus vulgaris is strongly related to genetics

A

TRUE

Jewish and Mediterranean decent

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27
Q

what are the physical symptoms of pemphigus vulgaris?

A

Painful desquamative lesions, erosions or ulcerations.

Chronic course with recurrent bulla formation

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28
Q

Acantholysis (due to destruction of desmosomes) is a histological sign for what condition?

A

pemphigus vulgaris

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29
Q

in a patient suffering from pemphigus vulgaris, there will be circulating autoantibodies against ________________

A

interepithelial adhesion molecules

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30
Q

T/F: in pemphigus vulgaris, there will be elevated pericellular epithelial deposits of IgG and C3

A

true

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31
Q

what is Lupus erythematosus?

A

Autoimmune connective tissue disorders in which autoantibodies form to various CELLULAR constituents

32
Q

what are the characteristics of the lesions formed by Lupus erythematosus?

A

Central atrophic area with small white dots surrounded by irradiating fine white striae with a periphery of telangiectasia

33
Q

_________ _______ Lesions can be ulcerated and cannot be differentiated from leukoplakia or atrophic oral lichen planus

A

lupus erythematosus

34
Q

what are the histological characteristics of lupus erythematosus?

A

Degeneration of basal cells and increased WIDTH of the basement membrane.

Deposits of various Ig.s, C3 and FIBRIN along the basement membrane

35
Q

T/F: lupus erythematosus is associated with degeneration of basal cells and decreased width of the basement membrane

A

false

Degeneration of basal cells and increased width of the basement membrane

36
Q

the ______ forms of lupus erythematosus can be fatal

A

systemic

37
Q

what are the 2 major forms of lupus erythematosus?

A

discoid and systemic

38
Q

the _______ form of lupus erythematosus is the mild chronic form which affects skin and mucous membranes

A

discoid

39
Q

T/F: antimetabolite drugs used for immunsuppresion in the treatment of autoimmune and other diseases may cause ulcerations

A

true

40
Q

Swelling, ulceration, petecchia and erythema of gingiva are all found in patients with ________

A

leukemia

41
Q

_____% of patients with acute leukemia had oral signs of leukemia

A

69

42
Q

Fibroma/ focal fibrous hyperplasia is due to the _______ processes of periodontal soft tissues

A

reactive

43
Q

Sessile, well-circumscribed smooth-surfaced nodules are characteristics of what type of lesion?

A

fibromas & focal fibrous hyperplasia

44
Q

what are the characteristics of Calcified fibroblastic granulomas?

A
  • Often reddish and ulcerated reactive lesion
  • Fibrous proliferation in which bone- or cementum-like hard tissue is formed
  • Highly cell-rich areas below ulcerated sites
45
Q

what is the differential diagnosis of a calcified fibroblastic granuloma?

A

Pyogenic granuloma

46
Q

what clinical signs are associated with Pyogenic granuloma?

A
  • Ulcerated
  • Reddish or bluish, sometimes lobulated, sessile or pedunculated. Bleeding is common
  • Highly vascular with chronic inflammatory cells
47
Q

what is a differential diagnosis for pyogenic granulomas?

A

Pregnancy tumor

48
Q

characteristics of Peripheral giant cell granulomas:

A
  • can occur anywhere on the gingival mucosa
  • Pedunculated (has a stalk), sessile (broad base),
    red or purple, commonly ulcerated
  • Focal collection of multi-nucleated osteoclast-like
    giant cells
  • lesions probably originate from the periodontal ligament
49
Q

what is the differential diagnosis for peripheral giant cell granulomas?

A

focal fibrous hyperplasia

50
Q

name all the periodontal tumors associated with REACTIVE processes of periodontal SOFT tissues:

A

1) Fibroma/ focal fibrous hyperplasia
2) Calcified fibroblastic granuloma
3) Pyogenic granuloma
4) Peripheral giant cell granuloma

51
Q

Periapical cemental dysplasia is a ______ process of periodontal ______ tissues

A

Reactive processes of periodontal hard tissues

52
Q

characteristics of periapical cemental dysplasia:

A
  • Fibrous-osseous cemental lesions
  • Tooth is usually vital.
  • Usually no symptoms
  • Periapical bone is replaced by cellular fibroblastic tissue through a cementoblastic phase
53
Q

what is the differential diagnosis for Periapical cemental dysplasia

A

Cemento-ossifying fibroma and fibrous dysplasia

54
Q

T/F: 4-5 different types of papillomas can occur

A

true

55
Q

what are the physical characteristics of papillomas?

A

Exophytic, pedunculated or sessile lesions. Reddish/normal or whitish/gray color

A granular/moruloid or filiform/digitated surface

56
Q

what is commonly found inside papilloma lesions?

A

the Human Papilloma Virus

57
Q

characteristics of Verruca vulgaris (a type of papilloma)

A
  • less common in oral mucosa compared to skin
  • Sessile, exophytic or raised lesion with a whitish surface
  • Papillomatous surface with hyperkeratinization
    and elongated rete ridges
58
Q

Peripheral odontogenic tumors are _______ lesions of periodontal soft tissue

A

benign

59
Q

where are peripheral odontogenic tumors generally found?

A

Generally detected in the soft tissue around unerupted teeth

60
Q

Ameloblastomas are derived from ____________

A

odontogenic epithelium

61
Q

T/F: Squamous odontogenic tumors are malignant

A

false- they are benign

62
Q

Squamous odontogenic tumors are derived from where?

A

Derived from pdl, presumably from epithelial rests of Malassez

63
Q

A ________________ is a Slow-growing neoplasm forming hard tissue around the apex of a tooth

A

Benign cementoblastoma

64
Q

what are the general characteristics of Squamous cell carcinomas?

A
  • found in mandible, posterior to the premolars
  • nodular lesions, often with ulceration and surrounding leukoplakia
  • Regional lymph-node metastasis is common
65
Q

________________ are usually caused by soft tissue metastasis from lung cancer

A

Metastasis to the gingiva

66
Q

T/F: Most of the metastasis cases are carcinoma and not sarcoma

A

true

67
Q

there is a reoccurrence of Kaposi’s sarcoma in what population group?

A

AIDS patients

68
Q

T/F: Primary malignant lymphoma is rare in the oral cavity

A

true

only seen in AIDS patients

69
Q

only ____% of osteosarcomas occur in the jaw

A

7%

70
Q

Swelling, tenderness, pain and loosening of teeth are frequent symptoms of what malignant condition?

A

Langerhans cell disease (Histiocytosis X)

71
Q

name the 5 cysts of the periodontium

A

1- Gingival cyst

2- Lateral periodontal cyst

3- Inflammatory paradental cyst

4- Odontogenic keratocyst

5- Radicular cyst

72
Q

Deposits of C3, IgG and other Ig.s in the basement membranes are found in what condition?

A

pemphigoids

73
Q

pemphigoids are caused by _____________ reactions

A

auto-antibody

74
Q

____________-mediated cell destructive processes may be involved in the pathogenesis of pemphigoids

A

compliment

75
Q

_____________ is the breakdown of the spinous bridges in epithelium

A

Acantholysis

76
Q

vascular lesions formed by dilatation of a group of small blood vessels is characteristic of what condition?

A

lupus erythematous

77
Q

Name the condition with the following characteristics:

Periapical bone is replaced by cellular fibroblastic tissue through a cementoblastic phase

A

Periapical cemental dysplasia

perio exam 2 (11 decks)

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