Vesiculobullous and Immune Disease Flashcards
What are some local immunological oral diseases?
- Apthous ulcers
- Lichen planus
- OFG
What are some systemic diseases with local effects?
- Erythema multiforme
- Pemphigus
- Pemphigoid
- Lupus erythematosis
- Systemic sclerosis
- Sjogrens syndrome
What type of hypersensitivity reaction is Erythema multiforme?
- Type 3 hypersensivity
What are some cell mediated immunity disease?
- Aphthous ulcers
- LP
-OFG
What are some antibody mediated immunity disease?
- Pemphigus
- Pemphigoid
What is the difference between epitopes and antigens?
- Antigens are the big immunological site in which antibody bind to it
- Epitope is the specific part of the antigen to which the antibody binds
Immunologically what happens during skin disease?
- Auto-antibody attack on skin components causing loss of cell-cell adhesion
- Causes loss of desmosomes to hemidesmosome by desmoglein attachment allowing cell layers to split
- Split forms in the skin
- Fills with inflammatory exudate
- Forms vesicle/blister
What is the difference between vesicle and blister?
- Vesicles 1-2mm
- Blister largers
What test is the most useful when suspected immuno bolus condition?
- Direct immunoflurorescnce
- Antibody mediated tissue disease
- Antibody causing disease targeted as it is bound to tissue, antigen containing fluorescein that binds to antibody
- If present then fluorescien shows up
What is indirect immunofluorescence ?
- Circulating antibody not yet bound to tissue
- Detected by immunofluorescnce from plasma sample
- Not always useful for diagnosis but good for monitoring disease activity
What is erythema multiforme?
- Spectrum disorder of immunogenic related skin and mucosa ulceration with variable orofacial involvement
What is the onset for erythema multiforme? What response does it create?
- Acute onset due to antigens being presented have been met before therefore antibodies rapidly produced from memory B cells
- Antigens and antibodies bind forming a complex in circulation and now unable to pass through capillaries
- When the large Complex gets to the tissues it becomes wedged and activates complements within the blood vessels causing a perivascular response
- Blistering or ulceration of the tissues
Where on the body can lesions of erythema multiforme be shown?
- Skin
- Genital
- Oral
- Oropharyngeal
- Combo of these
- Called a spectrum disorder
What is the term given to the most extreme form of erythema multiform? Where does it present on the body?
- Stevens-Johnsons syndrome
- Severe multisystem involvement
- Skin, conjunctivae, nose, pharynx, mouth, genital
In oral erythema multiforme what mucosa can be involved?
- All types of mucosa including keratinsed due to the lesion affecting capillaries
What are the lesions of oral erythema multiforme similar to?
- Primary herpetic gingivostomatitis
What is the aetiology of oral erythema multiform?
- Reactivation of herpes simplex virus triggers the immune reaction leading to this type 3 hypersensitivty (can give aciclovir prophylactically)
-Mycoplasma