Immune mediated Flashcards
Is Desquamative Gingivitis a specific disease?
No, it is a clinical term only.
What kind of diseases is Desquamative Gingivitis associated with?
Several vesiculoulcerative diseases.
Name diseases associated with Desquamative Gingivitis?
Erosive lichen planus and Mucous membrane pemphigoid.
What are the clinical features of Desquamative Gingivitis?
Erythema with loss of stippling, vesicle bulla, erosion, and pain.
What is the recommended treatment for Desquamative Gingivitis?
Biopsy lesional and adjacent normal epithelium.
What kind of disease is Mucous Membrane Pemphigoid?
An autoimmune disease.
What oral condition is associated with Mucous Membrane Pemphigoid?
Desquamative gingivitis.
What might be seen intraorally in Mucous Membrane Pemphigoid?
May see intact blisters.
What are the clinical features of Mucous Membrane Pemphigoid?
Ocular lesion (25%), symblepharon, entropion, trichiasis.
What immunofluorescence result is associated with Mucous Membrane Pemphigoid?
Positive direct immunofluorescence.
What are the treatments for Mucous Membrane Pemphigoid?
Refer to ophthalmologist and manage oral lesions with steroids.
What kind of disease is Pemphigus Vulgaris?
An autoimmune disease targeting epithelial desmosomal complex.
What is notable about the oral signs of Pemphigus Vulgaris?
Oral signs are first to show and last to go.
What are the clinical features of Pemphigus Vulgaris?
Ragged erosions and ulcerations, flaccid bullae on skin, oral blisters rarely seen, and a positive Nikolsky sign.
How should samples be taken for Pemphigus Vulgaris?
Sample lesional periphery for direct immunofluorescence.
What are the treatments for Pemphigus Vulgaris?
Systemic corticosteroids and referral to rheumatology and/or dermatology.
What is Paraneoplastic Pemphigus associated with?
Lymphoma or leukemia.
What condition is Paraneoplastic Pemphigus similar to?
Pemphigus vulgaris with hemorrhagic crusting of lips.
What do skin lesions of Lichen Planus look like?
Purple, pruritic, polygonal papules.
Where are skin lesions of Lichen Planus typically found?
Flexor surfaces and base of spine.
What are the clinical features of Lichen Planus?
Lace like appearance, buccal mucosa, tongue, gingiva, symmetric distribution of interlacing white lines, and 25% of cases have candidiasis.
What are the treatments for Lichen Planus?
Anti-fungal medications, topical corticosteroids, more frequent cleanings, home hygiene, and discourage screw retained prostheses.
How common is Recurrent Aphthous Stomatitis?
Very common.
What kind of condition is Recurrent Aphthous Stomatitis?
Immunologically mediated condition.
What are the characteristics of minor aphthae?
Most common, shallow ulcer with erythematous halo.
What are the characteristics of major aphthae?
Larger, deeper ulcer, longer duration, and may be associated with HIV or other immunocompromised conditions.
What are the characteristics of herpetiform aphthae?
Numerous small lesions.
What is the treatment for Recurrent Aphthous Stomatitis?
Topical corticosteroids.
What percentage of Erythema Multiforme cases have a precipitating cause?
50%.
What usually precipitates Erythema Multiforme?
Usually infection (herpes, m. pneumoniae), less commonly drugs.
What is the difference between minor and major Erythema Multiforme?
Minor = skin and/or oral, Major = 2 or more mucosal sites with skin.
What are the characteristics of Erythema Multiforme lesions?
Targetoid lesions, ragged margins, hemorrhagic crusting of lips.
What is the treatment for Erythema Multiforme?
Corticosteroids.
What is Behcet Syndrome associated with?
Oral aphthous ulcers, genital ulcers, and uveitis.
What do the ulcers from Behcet Syndrome look like?
Similar to minor, major, or herpetiform aphthae, predilection for soft palate and oropharynx.
What is Stevens Johnson Syndrome and Toxic Epidermal Necrolysis triggered by?
Drug exposure.
What happens to epithelial cells in Stevens Johnson Syndrome and Toxic Epidermal Necrolysis?
Apoptosis.
How much of the body is affected in SJS vs TEN?
SJS if less than 10% of body, TEN if more than 30% of body.
Where does Stevens Johnson Syndrome and Toxic Epidermal Necrolysis begin?
On the trunk.
What are patients with Stevens Johnson Syndrome and Toxic Epidermal Necrolysis susceptible to?
Infection and electrolyte imbalance.
What kind of immunity is involved in Lupus Erythematosus?
Immune mediated involving humoral and cell mediated immunity.
What kind of disease is Systemic Lupus Erythematosus?
Systemic disease.
What are the clinical features of Systemic Lupus Erythematosus?
Butterfly malar rash, Libman sacks endocarditis, oral ulcerations in 5-25% (up to 40%), similar to erosive lichen planus.
What are the clinical features of Chronic cutaneous lupus erythematosus?
Scaly patches and oral lesions like erosive lichen planus.
How is Lupus Erythematosus diagnosed?
With anti-dsDNA antibodies and anti-sm antibodies.
What is the treatment for Lupus Erythematosus?
Avoid sunlight and use corticosteroids or anti-malarial drugs.
