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Oral Path CUdental vesiculobullous


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_____ is serous clear fluid filled.
A large vessicle a.k.a. ______.
A purulent filled papule.
An epithelial lined cavity.
An elevated solid lesion < 5 mm.
An elevated solid lesion > 5 mm.
95 % of oral primary herpes is due to HSV-__ while genital herpes is caused by HSV-__.
1, 2 (linked to cervical cancer)
Herpes mode of transmission?
physical contact
Most cases of primary herpes occur btween the ages of ___ and ___.
0.5, 5
The incubation period of primary herpes is ____.
2 weeks
T/F Herpetic lesions affect both keratinized and non-keratinized mucosa.
Herpes runs a __ to __ day course.
7 to 14
Define gingivostomatits
edematous, intense erythema and painful gingiva
A 5 year old patient presents with ulcers which show a yellow, fibrinous base with a erythematous halo. The patient also suffers from fever, headache, weight loss and swollen lymph nodes. Dx: _______.
Primary Herpes
Lab results: biopsy shows vessicles, multinucleated giant cells and PCR is positive for HSV-1 virus. Dx: ________.
Primary herpes
A patient complains of prodromal sx's including itching burning and pain 6-24 hrs prior to multiple, fragile group lesions appearing on the vermilion. According to her hx she is stressed, immunosupressed and has significant sun exposure. Dx: _____.
Secondary herpes (also found on palate or attached gingiva (masticatory mucosa))
Herpes infection of the finger either primary or secondary.
herpetic whitlow
The latent herpes virus is sequestered in the __________.
trigeminal ganglion
Primary VZV cause _______ while secondary cause _____.
chicken pox, herpes zoster (shingles)
VZV is transmitted via ______. The virus multiples in ______ and is very contagious yet self limiting.
droplet inhalation, macrophages
An 65 year old male recently treated with chemo/radioation (immunocompromised) presents with prodrome pain and paresthesia followed by a unilateral vesicular, pustular, ulcerating eruptions. Dx: _______.
Herpes zoster
_________ occurs in 15% of those affected by herpes zoster after the lesions have healed causing burning and throbbing to the previously infected area and is aggravated by light touch.
post herpetic neuralgia
________ syndrome is due to herpes zoster involvement of the facial and auditory nerves causing possible unilateral facial paralysis, vesicles of the external ear, tinnitis, deafness and vertigo.
Ramsay Hunt
Hand, foot and mouth disease is is a common childhood infection caused by the _______ virus. It is highly contagious and is spread via __________. Oral vessicles which rupture and ulerate are covered by a yellow fibrinous membrane surrounded by a red hal
coxsackie (A16 or A10), airborne or fecal-oral, non-keratinized
A child complains of acute onset phayngitis and dysphagia in late August. A macular erythematous area preceded a vessicular eruption followed by ulceration of the posterior oral cavity (soft palate and tonsilar pillars. Dx:______.
Herpangina is caused by the ________ virus. It has a one week incubation and a self limiting course of _____ weeks
Coxsackie group A, 1-2 week course
Two forms of measles are ________, due to the paramyxovirus, and ________ caused by the togavirus.
Rubeola, Rubella (German measles)
Rubeola or Rubella: children-fever, rash, respiratory, photophobia
Rubeola or Rubella: mild symptoms, Forcheimer's sign (dark red palatal papules)
Rubeola or Rubella: may cause congenital defects in developing fetus especially in first trimester leading to deafness (80%), heart disese and cataracts.
Rubeola or Rubella: Koplick spots, small red macules with white necrotic centers preceding skin rash and Warthin Findlay giant cells (multinucleated giant cells in lymphoid tissue).
Rubeola or Rubella: complications include encephalitis, thrombocytopenic purpura, ities of immunocompromised.
Rubeola or Rubella: contagious from 1 week prior to rash to 5 days after, last outbreak was in the 60's
A middle aged patient of Jewish decent presents with painful shallow ulcers leading to intraepithelial blisters on non-keratinized mucosa with a + Nikolsky's sign. According to her med hx she has an autoimmune disorder. Dx:____
pemphigus vulgaris
Pemphigus vulgaris is differentiated histologically by the presence of free floating acantholytic spinous cells in blister fluid called ______. The remaining basal cells form a ______ row due the detruction of desmoglein __, a componet of desmosomes foun
Tzanck cells, toombstone, 3, epithelial
Steroids are used to treat pemphigus. Consequences of using long term steroids include: osteoporosis, diabetes, problems with healing and infection including ________and ______ syndrome.
candidiasis, Cushing's
________ pemphigus is an autoimmune disease triggered by malignant or benign tumors (usually leukemia or lymphoma) resembles oral pemphigus accompanied by severe heorragic, crusted chelitis and ocular lesions (70%).
Previously known as desquamative gingivitis ____________ is typically found in females (50-60's, 2:1) due to autoantibodies directed against basement membrane antigens causing _______ gingival bullae and vessicles rarely affecting the skin. _____ adhesio
Mucous membrane pemphigoid (MMP), subepithelial, ocular (symblepharon)
Histologically MMP shows _________ clefting due to autoantibodies (not found circulating) to _______________ which anchor the epithelium to subepithelial tissue. Tx is usually topical ______ placed in custom trays.
subepithelial, hemidesmosomes, corticosteroids
Bullous Pemphigoid usually have detectable circulating ________ in serum which also attack the basement membrane resulting in lessions identicle to MMP yet are also found on the ____.
autoantibodies, skin
Pemphigus or pemphigoid: tissue ab IgG, IgA and C3
pemphigoid (pemphigus shows no IgA)
Pemphigus or pemphigoid: circulating auto-IgG
pemphigus (pemphigoid no circulating)
Pemphigus or pemphigoid: target proteins Laminin 5 and BP180
Pemphigus or pemphigoid: intraepithelial vessicles
Pemphigus or pemphigoid: subepithelial vessicles
Pemphigus or pemphigoid: sites = oral and eyes
Pemphigus or pemphigoid: sites = oral and skin
Pemphigus or pemphigoid: prognosis = fair, significant mortality
Pemphigus or pemphigoid: prognosis = good
____________ is an autoimmune disease showing IgA in tissues. It is associated with gluten-sensitive enteropathy of young middle aged s causing pruritic lesions of elbows shoulders and buttocks rarely found in the oral cavity
Dermatitis herpetiformis
_________ is a chronic autoimmune disease of the skin commonly affecting mucous membranes including the gingiva causing bullae then ulcers. Neutrophils and eosinophils fill the area between epithelium and CT with linear IgA deposits.
Linear IgA disease
______________ is a hereditary disease causing an attachment defect of epithelial cells to underlying CT which leads to blisters and bulla formation after minor truama.
Epidermolysis bullosa

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