Skin and Mucosal Disease 1 Flashcards
Clinical term Red, Painful friable gingiva May desquamate easily with minimal trauma May be Nikolsky positive Differential Diagnosis (partial list) • Erosive lichen planus • Pemphigus vulgaris • Mucous membrane pemphigoid
Desquamative gingivitis
What are the 3 things mentioned that are considered to be desquamative gingivitis?
- Erosive lichen planus
- Pemphigus vulgaris
- Mucous membrane pemphigoid
- Immunologic mediate chronic mucocutaneous disorder of adults
- “4 P’s”
- Polygonal
- Purple
- Pruritic
- Papules
Lichen planus
What are the 4 P’s of lichen planus?
- Polygonal
- Purple
- Pruritic
- Papules
- Bilateral asymptomatic white lesions of the buccal mucosa
- Wickham striae
- Plaque-like areas
Reticular lichen planus
•Bilateral symptomatic erythematous areas with fine white radiating striae •Central ulceration •Desquamative gingivitis
Erosive Form of
Lichen Planus
Which form of lichen planus has a low risk of malignant transformation without being premalignant?
Erosive lichen planus
Histopathology of \_\_\_\_\_\_\_ •Hyperkeratosis •Saw tooth rete ridges •Band- like infiltrate of lymphocytes •Liquefaction degeneration of basal cell layer
Lichen Planus
•Group of autoimmune diseases •Autoantibodies against desmosomal proteins •Pemphigus vulgaris • Most common • Most severe • Most extensive oral involvement •Other forms • Pemphigus vegetans • Pemphigus foliaceous • Pemphigus erythematosus
Pemphigus
- Progressive chronic disease of middle-aged adults
* Multiple painful ulcers proceeded by bullae
Pemphigus Vulgaris
•Autoatibodies to Desmoglein-3 •Glycoprotein component of desmosomes •Tzank cells
Pemphigus vulgaris
- Oral lesions proceed skin lesions in half of cases
- Prognosis improved if treated early
- May be fatal without treatment
Pemphigus vulgaris
Histopathology of
_______
•Acantholytic process
•Tzank cells
Pemphigus Vulgaris
_____ pemphigus
• Associated with a malignancy
• Lymphoma
• Leukemia
Paraneoplastic
Pemphigus
In a study mentioned in lecture, what percentage of pemphigus vulgaris is on soft palate?
75%
________ is a general term for a group of disease processes.
• Oral mucous membrane pemphigoid if lesions are confined to oral mucosa
• Cicatricial pemphigoid if involvement of ocular mucosa
• Bullous pemphigoid if involvement of the skin
Mucous membrane pemphigoid
• Chronic, autoimmune blistering mucocutaneous disease • Autoantibodies to basement membrane antigens • Laminin 5 (epiligrin) • BP180 • Cicatricial pemphigoid • Ocular scarring • Symblepharon and blindness
Mucous
Membrane
Pemphigoid
Older adult females Oral, conjunctival, nasal, esophageal, laryngeal, vaginal mucosa Skin - infrequesnt
Mucous membrane pemphigoid
Oral Lesions of _________
•Vessicles, bullae, ulcerations •Desquamative gingivitis
Mucous Membrane Pemphigoid
Gentle pressure causes layers of tissue to move and separate Sign of skin or mucosal fragility demonstrated on grossly normal tissue
Nikolsky sign
