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Oral Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Marcia Ramos-e-Silva, José Wilson Accioly Filho, Sueli Carneiro, Nurimar Conceição Fernandes
Clinical presentation: Among the oral forms are reticular (Figure 16.13), which is the most frequent, atrophic, erosive or ulcerated, linear or annular, hypertrophic or leukoplastic (Figure 16.14), bullous, and pigmented. There may also be desquamative gingivitis (Figure 16.15) that causes erosion, atrophy, and scaling of the gums. Oral lesions predominate on the cheek mucosa, tongue, and gums, and it appears that the erosive and atrophic forms have a higher risk of malignancy.
Mucous membrane pemphigoid
Published in Lionel Fry, Atlas of Bullous Diseases, 2020
The other causes of desquamative gingivitis include pemphigus and lichen planus. Pemphigus and Behçet’s syndrome may present with persistent oral lesions. Linear IgA disease may be associated with persistent mouth ulcers. Immunofluorescent studies of uninvolved tissue and biopsies of the involved sites for routine histology may be necessary to diagnose lichen planus.
Mucous membrane pemphigoid
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Dipankar De, Sheetanshu Kumar, Sanjeev Handa
Oral mucosa is often the first and most common site of involvement by MMP, gingiva being the most common site in the oral cavity [1,2,4,24]. Typical lesions include diffuse erythema, blisters, erosion, and ulceration. Lesions usually appear on the attached gingiva. Desquamation of gingival tissue (called desquamative gingivitis) is the most common intraoral manifestation in MMP, which is also seen in pemphigus vulgaris and lichen planus [25]. The frequency of involvement of gingiva and other sites within the oral cavity is presented in Table 11.2.
Current status and prospects for the diagnosis of pemphigus vulgaris
Published in Expert Review of Clinical Immunology, 2021
Ali Nili, Ali Salehi Farid, Masoud Asgari, Soheil Tavakolpour, Hamidreza Mahmoudi, Maryam Daneshpazhooh
According to the clinical manifestation of the disease, PV can be divided into three types: mucosal dominant (with antibodies only against Dsg3), mucocutaneous (with antibodies against Dsg1 and Dsg3), and cutaneous subtypes (antibody against Dsg1and Dsg3) [8–10]. Most PV patients initially present with oral lesions, and up to 90% of them may endure oral erosions in the course of their disease. The oral lesions typically affect the buccal, hard, and soft palate, the floor of the mouth, lips, and gingiva. The lesions are composed mostly of flaccid blisters, which break rapidly, causing erosive lesions which extend laterally. The gingival involvement leads to desquamative gingivitis [11]. Although the erosions can be symptomless, some patients complain of severe pain, decreasing food intake resulting in weight loss, and impaired quality of life. Other less frequent mucosal sites such as nasal, pharynx, larynx (causing hoarseness), anogenital mucosa, and esophagus may also be affected [8,12,13].
Efficacy of 0.1% tacrolimus in long-term management of erosive lichen planus
Published in Journal of Dermatological Treatment, 2021
Amber Kiyani, Kanwal Sohail, Muhammad Humza bin Saeed
All patients had bilateral buccal mucosa involvement. Desquamative gingivitis was seen in 6 patients, labial mucosal involvement in 1, and tongue lesions in 3. Involved areas showed erythema, erosions and ulceration with white striations at their periphery. At least, one site was biopsied to confirm the diagnosis of lichen planus histologically. All cases were diagnosed as true OLP with only a T-cell lymphocytic infiltrate. Six patients also had positive direct immunofluorescence (DIF) results for fibrinogen deposition at the basement membrane zone. Although DIF is recommended for establishing diagnosis of OLP and distinguishing it from chronic ulcerative stomatitis, most patients are unable to afford it due to high cost.
COVID-19 and oral diseases: Assessing manifestations of a new pathogen in oral infections
Published in International Reviews of Immunology, 2022
Afsar R. Naqvi, Joel Schwartz, Daniela Atili Brandini, Samantha Schaller, Heba Hussein, Araceli Valverde, Raza Ali Naqvi, Deepak Shukla
Only a handful of studies have assessed the impact of oral health in COVID-19 subjects and few studies examined periodontal health in virus-infected subjects. COVID-19 patients are reported to exhibit a broad spectrum of oral manifestations [51]. In a recent questionnaire based study, patients diagnosed with COVID-19, who were experiencing mild symptoms, were assessed for oral manifestations of COVID-19. A majority (56%) of the patients reported to experience xerostomia, dry mouth resulting from reduced saliva flow. Xerostomia is linked to gingival disease activity through the accumulation of dental plaque and can exacerbate gingival inflammation [52]. Indeed, nine patients experienced plaque-like changes in their tongue. Six subjects (4.7%) reported gingival bleeding. Out of the six patients that experienced current oral bleeding, half of them have also experienced oral bleeding in the past. However, no spontaneous bleeding was reported by any of the patients. Small sample size, self-reporting analysis and inclusion of mild symptomatic subjects may have skewed the outcomes of this study. In addition, the usage of several drugs intended to target COVID-19 may intensify certain oral conditions because of COVID-19, especially the oral conditions that possess autoimmune etiology. A COVID-19 patient released from hospital after treatment with antibiotics (lopinavir 200 mg), corticosteroids (ritonavir 50 mg), and antiviral drugs (hydroxychloroquine 200 mg) developed skin rashes and blisters in the oral mucosa [53]. The subject showed desquamative gingivitis, which may be attributed to prior diseases or allergic response. Prescription of the anti-inflammatory drug as prednisolone in conjunction with hyaluronic acid and chlorohexidine improved the oral symptoms indicating that oral inflammation may occur as secondary outcome of COVID-19 treatment.