vesiculobullous and immune mediated disease Flashcards
What are the different types of immune mediated diseases?
Hypersensitivity - type 1 - 5
Immunogenicity mediated diseases through either cell mediated immunity or antibody mediated immunity
Name 3 immunological oral diseases local to the mouth
Aphthous ulcers
Lichen planus
Orofacial granulomatosis
Name 3 systemic diseases with local effects in the oral cavity
Any from:
- erythema multiforme
- pemphigus
- pemphigoid
- lupus erythematosis
- systemic sclerosis
- Sjögren’s syndrome
What is the difference between a vesicle and blister?
Vesicle - 1-2mm in size
Blister - larger than 2mm in size
What are desmosomes and hemidesmosomes?
Desmosomes attach epithelial cells to each other
Hemidesmosomes attach epithelial cells to the basement membrane
They are both the target for many antibodies in vesiculobullous diseases causing cell layers to split
What is direct immunofluorescence?
A manufactured second antibody with a fluorescein marker binds to the first antibody which is already bound to tissue
Very useful for vesiculobullous diseases
What is indirect immunofluorescence?
Looks for a circulating antibody not yet bound to the tissue
Isn’t useful for diagnosis, good for monitoring disease activity and treatment need
Name 5 vesiculobullous conditions
Erythema multiforme
Pemphigus
Pemphigoid
Angina bullosa haemorrhagica
Bullous lichen planus
What is erythema multiforme?
Immunogenicity related skin and mucosa ulceration
Affects lips and anterior part of mouth
Heals within 2 weeks
How is erythema multiforme treated?
Systemic steroids
Systemic aciclovir in secondary care
Fluid intake
Analgesia
What is angina bullosa haemorrhagica?
Commonest blistering oral condition
Blood blisters in the mouth
Rapid onset, last about an hour then burst
Heals with no scarring within days
How is angina bullosa haemorrhagica treated?
No real treatment available
Chlorhexidine mouthwash and benzydamine spray
Reassure patient it is benign
Name 2 common causes of angina bullosa haemorrhagica
Eating
Steroid inhalers
