ch 09 allergies and immunologic diseases

Question 1

• Unknown etiology but could be irritation, stress, GI disease, hormonal changes, URI, viral infection or topical hypersensitivity.
• Elevated painful fungiform papillae, often red, white or yellow in color.
• Resolve on their own but steroid, anesthetics and coating agents have been tried.

Answer 1

transient lingual papillitis

Question 2

-One of the most common oral mucosal pathoses
-Prevalance - 5% to 66%
-Pathogenesis: various theories = different
things in different people
-primary immunodysregulation
-decrease of the mucosal barrier
-increase in antigenic exposure

Answer 2

recurrent aphthous stomatitis

Question 3

the three clinical variations of recurrent aphthous stomatitis

Answer 3

• minor apthous ulcerations
• major aphthous ulcerations
• herpetiform aphthous ulcerations

Question 4

Multisystem disorder
n Oral lesions first manifestation in 25% - 75% soft palate and oropharynx
n Oral involvement at some point 99% n Genital lesions 75%
n Ocular lesions 70% - 85%
n CNS involvement – 10% to 25%

Answer 4

Behcet’s syndrome

Question 5

A multisystem granulomatous disorder of unknown etiology
n Blacks affected 10 – 17 times more frequently than whites.
n Bimodal age predilection: 25-25 & 45-65
n Commonly appears acutely
n Dyspnea, dry cough, chest pain, fever, malaise, fatigue, arthralgia, weight loss
n Lungs, lymph nodes, skin, eyes, and salivary glands

Answer 5

Sarcoidosis

Question 6

noncaseating granulomas

Answer 6

sarcoid lesions

Question 7

Idiopathic abnormal immune reaction to ?
n  Biopsy shows multinucelated giant cells and granuloma, so you have to rule out Sarcoid,
Crohn’s disease,
Fungus infection,
Foreign body reaction

Answer 7

orofacial granulomatosis

Question 8

Orofacial granulomatosis + facial paralysis + fissured tongue

Answer 8

Melkersson-Rosenthal syndrome

Question 9

allergic mucosal reactions to systemic drugs

Answer 9

“stomatitis medicamentosa”

Question 10

allergic contact stomatitis

Answer 10

-food, gum, topicals, acrylics etc

Question 11

latex allergy:

Answer 11

allergic contact dermatitis

Question 12

unique inflammatory skin disease that involves the circumoral area

Answer 12

perioral dermatitis

-tx: metronidazole

Question 13

lichenoid contact stomatitis from dental resotorative materials

Answer 13

• amalgam

- similar to lichen planus

Question 14

• Diffuse edematous swelling
• Subcutaneous and submucosal connective tissue
• GI or respiratory tract
• Mast cell degranulation leads to histamine release
• IgE-mediated hypersensitivity reactions n Foods, cosmetics, topicals, rubber dam

Answer 14

angioedema (angioneurotic edema; quincke’s disease)