Disease that presents as ulcerated, "blood crusted" lips and target lesions on the skin
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
Disease that has oral ulcers but also has lips, eyes and genital involvement
Stevens-Johnson syndrome (EM Major)
Disease that presents as sloughing of large amounts of skin & mucosa and is triggered by drugs
Toxic Epidermal Necrolysis (TEN/ Lyell’s Disease)
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
Where are the oral lesions mainly seen with Benign Mucous Membrane Pemphigoid? (3)
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
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
Disease that results from an antibodies to hemidesmosomes
T/F: Oral mucosal involvement of bulls pemphigoid is uncommon, it is more skin involvement
What is the histological significance seen in pemphigoid?
clean epithelial separation from the lamina propria (sub epithelial split)
Immunofluorescence highlights attach within basement membrane
Uncommong autoimmune disease that presents with oral lesions
Bullous eruptions that rupture and yield jagged ulcerations
>50% mortality before corticosteroids
What is the significance of pemphigus histopathology?
Tombstoning--> from basal layer remaining attached tot he lamina propria
Immunfluorescence highlights attack between epithelial cells
T/F: Tzanck cells are presents in pemphigoid
Present in pemphigus
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
What are the two forms of lichen planus
reticular and erosive
what is the most common subtype of pemphigus?
Where is lichen planus most commonly found?
Erosive form of lichen planis is ____, ______ and _____
What are the 4 Ps of lichen planus
Which disease has the following histopathology:
Basal cell layer degeneration dissolution
Civatte bodies (apoptotic cells)
band-like T lymphocytic infiltrate
Lichen planus gingival lesions may have ____ cells, but lichenoid drug/ metal reactions have ____
First line treatment for Lichen Planus
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
Herpes simplex virus enters and replicates in what cells?
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
When do antivirals work on primary herpetic gingiostomatits?
When you catch it in the prodromal phase
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
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)
Pain experienced after the patient has had shingles