Vesiculobullous & Immune Disease Flashcards
what are examples of local immunological oral diseases?
- aphthous ulcers
- lichen planus
- orofacial granulomatosis
what are examples of systemic diseases that have local effects of oral disease?
- erythema multiforme
- pemphigus
- pemphigoid
- lupus erythematosis
- systemic sclerosis
- Sjogren’s syndrome
what type of hypersensitivity disease is erythema multiforme?
Type 3
- related to antigen antibody complexes
What type of immunogenic disease do aphthous ulcers come under?
cell mediated immunity
What type of immunogenic disease does orofacial granulomatosis come under?
cell mediated immunity
Many blistering skin conditions also…
Affect the mouth!
- skin & oral/genital mucosa share many common antigens & epitopes
what protein is the target for many of the antibodies involved in immunobullous diseases?
Desmoglein
What is erythema multiforme?
Spectrum disorder of Immunogenic related skin & mucosa ulceration with variable orofacial involvement
What is the aetiology of erythema multiforme??
- drugs
- herpes simplex
- mycoplasma
Which sex is more likely to suffer from erythema multiforme?
Males > females
How is erythema multiforme treated with drugs?
- prednisolone (up to 60mg a day)
- systemic aciclovir
What is angina bullosa haemorrhagica?
“blood blisters” in the mouth
- rapid onset appear in a few minutes
- last about 1 hour then burst
What might trigger angina bullosa haemorrhagica?
eating
Where are the most common sites of angina bullosa haemorrhagica?
buccal mucosa and soft palate
how is angina bullosa haemorhagica managed?
- no treatment available
- reassure patient that diseaae is benign
- explain triggers
What is pemphigoid characterised by?
SUB epithelial antibody attack
- thick walled blisters across full epidermis
what is citatritial pemphigoid?
mucosal lesions with scarring
in suspected pemphigoid where should the biopsy be taken?
PERI-lesion biopsy (not directly on ulcer)
what is the most useful test for patients with suspected pemphigoid?
direct immunofluorescence
what does pemphigoid cause?
separation of the epithelium and connective tissue causing ulcers
what immunofluorescence results suggest a patient has pemphigoid?
- linear staining along basement membrane
- C3 & IgG detected
what is symblepharon?
binding of eye surface to eyelid due to scarring from pemphigoid
how is pemphigoid managed?
- steroids
- immune modulating drugs eg azathioprine or mycophenolate
what is the commonest form of pemphigus?
Pemphigus vulgaris
