Vesiculobullous Disease

  1. Disease that presents as ulcerated, "blood crusted" lips and target lesions on the skin
    Erythema Multiforme
  2. Why cant you diagnose EM with just lesions in the oral cavity?
    Because the are non specific so they don't really help with the differential
  3. Disease that has oral ulcers but also has lips, eyes and genital involvement
    Stevens-Johnson syndrome (EM Major)
  4. Disease that presents as sloughing of large amounts of skin & mucosa and is triggered by drugs
    Toxic Epidermal Necrolysis (TEN/ Lyell’s Disease)
  5. What is the treatment for EM
    • Corticosteroids but it is self limiting so doing nothing can also work
    • can also give antivirals prior to steroids
  6. Where are the oral lesions mainly seen with Benign Mucous Membrane Pemphigoid? (3)
    • Soft palate
    • Buccal Mucosa
    • Gingiva
  7. Disease that presents with desquamative gingivitis, ulcers and odd inflammatory pattern, eye lesions with scarring of the lid to the conjunctiva
    Bullae filed with straw colored or hemorrhagic fluid
    when bullae rupture, gray-white membrane, raw erythematous undersurface
    Benign Mucous Membrane Pemphigoid
  8. What is a positive nickolsky sign?
    Take the end of a mirror and rub the area and then you come back to the area some time later and you see a bullae
  9. Disease that results from an antibodies to hemidesmosomes
    Bullous Pemphigoid
  10. T/F: Oral mucosal involvement of bulls pemphigoid is uncommon, it is more skin involvement
  11. What is the histological significance seen in pemphigoid?
    • clean epithelial separation from the lamina propria (sub epithelial split)
    • Immunofluorescence highlights attach within basement membrane
  12. Uncommong autoimmune disease that presents with oral lesions 
    Bullous eruptions that rupture and yield jagged ulcerations
    >50% mortality before corticosteroids
  13. What is the significance of pemphigus histopathology?
    • intraepithelial separation 
    • Tombstoning--> from basal layer remaining attached tot he lamina propria 
    • Immunfluorescence highlights attack between epithelial cells
  14. T/F: Tzanck cells are presents in pemphigoid

    Present in pemphigus
  15. Common mucotaneous disease that is more prevalent in adult females and most commonly found lesions are on the skin but can in the oral cavity
    Lichen planus
  16. What are the two forms of lichen planus
    reticular and erosive
  17. what is the most common subtype of pemphigus?
    pemphigus vulgaris
  18. Where is lichen planus most commonly found?
    Buccal mucosa
  19. Erosive form of lichen planis is ____, ______ and _____
    • bilateral 
    • multifocal 
    • symmetric
  20. What are the 4 Ps of lichen planus
    • Purple
    • Polygonal
    • Papules
    • Pruritic (itchy)
  21. Which disease has the following histopathology:
    Basal cell layer degeneration dissolution
    Civatte bodies (apoptotic cells)
    band-like T lymphocytic infiltrate
    Lichen Planus
  22. Lichen planus gingival lesions may have ____ cells, but lichenoid drug/ metal reactions have ____
    • Plasma
    • Esosinophils
  23. First line treatment for Lichen Planus
    Topical sterioids
  24. Common disease that 85% of the general population has antibodies to
    enters through breaks in skin on intact mucosal surfaces 
    initial infection largely asymptomatic
    Herpes Simplex Virus
  25. Herpes simplex virus enters and replicates in what cells?
    epithelial cells
  26. Disease that presents as Malaise, fever, pain, cervical lymphadenopathy, fever, stomatodynia and shows clustered vesicular eruptions (perioral and prenatal) with fiery red and painful gingiva
    Primary herpetic gingivostomatitis
  27. When do antivirals work on primary herpetic gingiostomatits?
    When you catch it in the prodromal phase
  28. Starts as a fluid filled bull and then ruptures and crusts 

    Present as “Coin lesions” because the vesicles cluster together and you can place a coin over it and get the form
    Presents on keratinized tissue
    Recurrent herpes simplex
  29. Ulcers that present on ONE side, affecting ONE dermatome 

    Can be in the oral cavity but mostly will be seen in the trunk region along one nerve region
    Herpes Zoster (Shingles)
  30. Pain experienced after the patient has had shingles
    Post herpetic neuralgia
Card Set
Vesiculobullous Disease
Final Exam Material