oral pathology, Autoimmune disease
Terms
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- a minor apthae
- Recurrent apthous ulcers (RAU)can sometimes be caused by citric acid, peanuts, milk and beer. Stress seems to make this condition worse.
- True recurrent apthous ulcers only occur where?
- moveable portion of the mucosa.
- Bechet's syndrome
- a multisystem disease usually presenting with ocular, oral and genital lesions. MOst likely seen in females
- Reiter's Disease
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a multisystem disease most commonly found in males. same clinical manifestations a BEchets only arthiritis is included and genital lesions include inflammation of the penis (balanitis).
Treatment is the use of anti-inflammatory drugs - Oral manifestations of Major apthae
- large cratered ulcerations of mucosal surfaces with piled up erythamatous margins of long duration; ulcers heal in weeks to months, usually without scarring
- steven-johnsons
- males most likely to get this disease
- Lupus erythematosus
- more common in females. about 50 times moe likely to get this than males. Genetic disorder that is very difficult to diagnose, autoimmune.
- oral manifestaions of lupus
- lesions present as erythmatous plaques or erosion (thinning out not a break)affecting the bucal mucosa, gingiva, palate, and vermillion zone; ulcerations are seen frequently
- lupus
- considered a connective tissue disease(autoimmune stimulant= nuclie)
- erosive (bullous) lichen planus
- a skin disease affecting the basal layer of the epithelium suspected to be autoimmune
- erosive and bullous
- least common; exhibits erythemous erosions ans ulcerations most common on the posterior buccal mucosa and attached gingiva
- bullous lichen planus
- a variant of erosive in which vesicles or bullae precede ulcerations
- wickham's strae
- may be visible at periphery of lesion; may or may not accompany skin lesions
- recurrent apthous ulcers
- lesions are usually single, but may occur in crops; adjacent lesions may coalesce to form larger areas of ulceration; usually heal in 7-10 days without scarring; multiple and multisystem lesions may be suggestive of BECHET's syndrome
- Treatment for RAU
- palliative, multiple and frequent recurrence may respond to supervised steroid therapy; topical tetracycline reduces the likelihood of a secondary bacterial infection; recurrence is likely
- treatment for BEchet's syndrome?
- supervised steroid therapy, but may undergo spontaneous remission
- Periadenitis Mucosa Necrotica Recurrans (PMNR)
- Major apthae or Sutton's disease; considered to be an immune dysfunction
- Erythema multiforme
- a disease affecting the skin and mucous membranes.suspected to be caused by an immune dysfunction
- Steven-johnson's syndrome
- a multisystem disease of erythema multiforme usually involves ocular, oral and genital regions. (you must have all three of these symptoms to have this disease)
- treatment for Steven-Johnson's
- supervised steroid therapy with possible recurrence
- shallow necrotic center with red margin
- RAU
- clinical manifestaions of BEchet's syndrome?
-
*oral lesion- resemble RAU and tend to occur in multiple crops
*ocular lesions- include uveitis and/or conjunctivitis
*genital lesions-also exhibit painful lesions - Major apthae treatment:
- supervised steroid therapy
- erythema multifrome
-
lesions may exhibit multiple RAU-type or larger ulcerations; vescicles may occur early or exist at the margins of the ulcers
~ - steven-johnson's
- oral and genital lesions usually exhibit erythema multiform; ocular lesions consist of conjunctivitis or uveitis
- name the two types of lupus
-
chronic: affects the skin and mucous membranes (butterfly rash)
systemic: a multisystem disease that is occasionally fatal affects all internal organs
you can have both types of these - clinical manifestations of lupus
- antibodies are formed against the cell nucleus or other cytoplasmic antigens, patients often complain of malaise, weakness and an occasional low-grade fever
- what are the forms of erosive lichen planus
- erosive and bullous, bullous lichen planus and wickham's striae
- treatment for erosive lichen planus
- steroid therapy, may undergo spontaneous remission with possible recurrence
- Pempigus (pemphigus vulgaris, pemphigus vegetans)
-
a skin disease in which there is shedding of the skin. It attacks the desmosomes(they hold the epithelial together)
autoimmune; histologically an intraepithelial separation (above the basil layer) with Tzanck cells (free floating epithelial cells only seen in this disease)resembles a fried egg with a yolk in the middle - oral manifestations of pemphigus
- lesions present as apthae-like ulcerations or large irregular ulcerations with erythamous margins; vescicles or bullae may precede ulcerations. intraepithelial split
- clinical manifestations of pemphigus
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*antibodies are directed against desmosomes resulting in acantholysis(loss of cell to cell adhesion)
*individuals may exhibit a positive nikolsky sign (sloughing of epithelium after minor trauma)
*may have an ethnic or genetic predisposition; treatment- use of steroids - pemphigoid {benign mucous membrane pemphigid, cicaticial-(scar forming) pemphigoid}
- an autoimmune disease which effects the basil layer membrane area, antibodies are directed against hemidesmosomes resulting in subepithelial separation. Only affects mucosa
- oral manifestations of pemphigoid
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lesion exhibit painful ulcerations with erythematous margins on any mucosal surface
* desquative gingivitis- a clinical description of possible pemphigoid, positive nikolsky sign is frequently notes - clinical manifestations of pemphigoid
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bullous pemphigoid is considered a variant of cicatricial pempigoid, but autoimmune findings are not consistent.
Treatment use of steroids, may undergo periods of remission and exacerbation