Oral blistering diseases Flashcards
What are the two types of immunogenic reactions?
- Cell mediated
- Antibody mediated
What type of hypersensitivity reaction happens in Erythema multiforme?
Type 3
What 3 diseases are related to cell mediated immunity?
- Apthous ulcers
- Lichen planus
- Orofacial granulomatosis
What 2 diseases is related to antibody mediated immunity?
- Pemphigus
- Pemphigoid
Why might oral disease and genital/skin are commonly linked?
Because they share many common antigens and epitopes
What are antigens?
- Immunogenic site within a protein
What is epitope?
- A specific site in an antigen that antibodies bind
Describe the immunological process in blistering disease?
Auto-antibody attack on skin component cause loss of cell to cell adhesion resulting in a split which is filled by inflammatory exudate forming a vesicle or blister
What is the difference between a vesicle and a blister?
- Vesicle 1-2mm
- Blisters are larger
What exactly do autoantibodies attack that causes loss of cell to cell adhesion?
Desmosomes and Hemidesmosomes
Briefly describe what is a desmosome and a hemidesmosome?
Desmosome - an attachment that bind cells together
Hemidesmosome - anchor cells to basement membrane
Describe how direct immunofluorescence work?
- by manufacturing an antibody with a flour-scene marker that binds to the primary antibody in the affected tissue , confirming its presence
How should the tissue for direct immunofloursence be transported?
Fresh , avoid formalin as it may cause the loss of binding sites
What is indirect fluorescence? and when to use it?
- it confirms the presence of antibodies circulating in the plasma that is not yet bound to the tissue
- not reliable as a diagnostic aid but can be used for monitoring
What is erythema multiforme?
A spectrum disorder of immunogenic related skin and mucosa ulceration and blistering
What do we call the severe form of erythema multiforme?
Stevens-johnson-syndrome
3 parts of the body other than the mouth that can be affected by stevens-johnson syndrome?
- Skin
- Eyes
- Pharynx /nose