OD 36 - Orofacial granulomatosis Flashcards
What is the immune reaction of Crohn’s disease?
Dominant CD4 TH1 reaction induced
Brought only genetic/environmental causes
What are the oral features of Crohn’s disease?
Non-specific: angular chelitis/ulceration
Specific: diffuse nodular swelling of lip, cobblestone mucosa, eythema/swelling of gingiva
What is the diagnostic triad of Melkersson-Rosenthal syndrome?
Have 2/3 of: fissured tongue, facial paralysis, persistent orofacial swelling (commonly lower lip)
What is cheilitis granulomatosa?
Painless enlargement of 1/both lips = recurrent (more commonly upper)
Recurrent swelling can lead to persistent, becoming firmer
What is the triad of Wegner’s granulomatosis?
Uncommon multisystem disorder - can involve oral cavity
• Necrotizing granulomatous lesions of upper+/or lower respiratory tract
• Systemic vasculitis
• Necrotizing glomulonephritis
Develops over 5-15 months depending on diagnostic delay
What are the oral signs of Wegner’s granulomatosis?
Oral lesions
Hyperplastic granular gingivitis - strawberry gingivitis
What is sarcoidosis?
Multisystem granulomatous disorder of unknown cause
Mainly caused by TB bacteria
Exaggerated immune response to antigens and self antigens triggering CD4 TH1 reaction
What are the 2 acute syndromes that can arise in sarcoidosis?
Lofgren’s - fever, erythema nodosum, arthralgia
Heerfordt-Waldenstrome - fever, parotid enlargement, anterior uveitis, facial nerve palsy
What are the orofacial presentation of sarcoidosis?
Soft tissue swelling
Major SG swelling (parotid mainly)
Ulcerations
What is TB?
Chronic infectious granulomatous disease caused by mycobacterium tuberculosis
Can cause oral ulceration - however RARE
What is a positive test for TB?
Ziehl-neelsen
