Lecture Summary: Immunologic Disorders

Question 1

canker sores are also called _____ and are the most common ______ oral ulcer

Answer 1

aphthous ulcers, non-traumatic

Question 2

causes of aphthous ulcers

Answer 2

immune dysfunction, stress, diet (acidic foods)

Question 3

aphthous ulcers are painful recurrent ulcers on ________ anywhere except ________

Answer 3

unattached mucosa, palate/gingiva

Question 4

aphthous ulcers are _______ with a ___ center and ___ border

Answer 4

crateriform (indented), pale, red

Question 5

characteristics of a minor canker sore

Answer 5

single, small(<1 cm), mildly painful ulcer that heals in a couple weeks

Question 6

characteristics of a major canker sore

Answer 6

multiple, large (>1 cm), very painful ulcers that heals in a couple months

Question 7

characteristics of a herpetiform canker sore

Answer 7

multiple small ulcers that look like herpes infection (“herpetiform”) but are not caused by HSV-1.

Question 8

major canker sores may require ____ tx, but minor and herpetiform usually _______

Answer 8

steroid, don’t require treatment

Question 9

Immune-mediated disorder affecting oral cavity and/or skin

Answer 9

lichen planus

Question 10

lichen planus is ______, more common in ____, onset is ____

Answer 10

sort of common (1%), women, middle age

Question 11

two types of oral lesions in lichen planus

Answer 11

reticular, erosive

Question 12

characteristics of lichen planus (reticular type)

Answer 12

• Most common
• Fine white lines (called “Wickham’s striae”) in lacy pattern (“reticular” means “web-like”)on buccal mucosa
• Usually asymptomatic; no need to treat

Question 13

characteristics of lichen planus (erosive type)

Answer 13

• Less common
• Painful ulcerated lesion surrounded by Wickham’s striae
• Some cases turn into cancer, so should biopsy to monitor for that.
• Treat with steroids

Question 14

Autoimmune disorder affecting skin and mucous membranes

Answer 14

pemphigus vulgaris

Question 15

“vesicle” means ____ blister; “bulla” means _____ blister

Answer 15

small, large

Question 16

pemphigus vulgaris mechanism: Patients have _______ against the little proteins that attach the cells of the _______ to each other. This causes the cells of the epidermis to detach from each other, forming ______ (that turn into ________) within the epidermis.

Answer 16

antibodies, epidermis, spaces, vesicles/bullae

Question 17

pemphigus vulgaris

• diagnose with ____
• treatment with _____

Answer 17

• biopsy

- oral steroids

Question 18

Autoimmune disorder affecting skin and mucous membranes in which lesions are vesiculobullous

Answer 18

benign mucous membrane pemphigoid

Question 19

BMMP mechanism: Patients have antibodies against the _________ (the basement membrane is the dividing line between the epidermis and dermis). This causes the epidermis to detach from the _____, forming spaces (that turn into vesicles/bullae) between the ______.

Answer 19

basement membrane of the epidermis, dermis, epidermis and dermis

Question 20

Since the vesicles are between the epidermis and dermis in BMMP, they are _____ than the vesicles in pemphigus vulgaris–and they tend _______

Answer 20

deeper, not to rupture as easily.

Question 21

BMMP characteristics
Diagnose with ____
Treatment: ______. May require additional drugs to ________

Answer 21

• biopsy

- oral steroids, suppress immune system

Question 22

Autoimmune disorder affecting eyes and mouth.

Answer 22

Sjogren syndrome

Question 23

Sjogren syndrome is more common in ______ (like other autoimmune disorders)

Answer 23

women

Question 24

Sjogren syndrome: patients have antibodies that destroy ___________

Answer 24

salivary and lacrimal glands.

Question 25

symptoms of sjogren syndrome

Answer 25

dry eyes (xerophthalmia) and dry mouth (xerostomia). Xerostomia predisposes patients to caries and candidiasis.

Question 26

sjogren syndrome diagnosis = ______

Answer 26

several criteria, including dry eyes, dry mouth, and the presence of autoantibodies.

Question 27

sjogren syndrome Tx = _________

Answer 27

supportive (eye drops, meticulous oral hygiene). No curative treatment yet

Question 28

those with sjogren syndrome by also have ________ and markedly increased incidence of ____

Answer 28

another autoimmune disease, lymphoma