Developmental And Immune Mediated Mucocutaneous Conditions

Question 1

What are the 2 other names of Erythema Migrans?

Answer 1

Geographic tongue, Benign Migratory Glossitis

Question 2

What causes erythema migrans and how common is it?

Answer 2

Probably immune mediated, 1-3 % of the population

Question 3

What is the erythema of erythema migrans caused by?

Answer 3

Atrophy of filiform papillae and shearing of parakeratin.

Question 4

What is it called when you have geographic tongue somewhere other than the dorsal aspect of the tongue?

Answer 4

Ectopic erythema migrans

Question 5

Treatment for geographic tongue

Answer 5

None needed, occasionally if painful with foods can be treated with potent topical steroids.

Question 6

Which type of lichen planus resolves after 7-10 years?

Answer 6

Cutaneous, mucosal is more chronic.

Question 7

Wickham’s striae and purple polygonal pruritic papules are clinical features of which immune mediated condition?

Answer 7

Lichen Planus

Question 8

What are the two oral forms of lichen planus?

Answer 8

Reticular (lacy white lines) and erosive (erythematous, may ulcerate)

Question 9

Clinical features of Oral Lichen Planus

Answer 9

Reticular LP (white lines), ELP, bilateral buccal mucosa, tongue, gingiva common but any intraoral surface and lips.

Question 10

Oral lichen planus has a malignant transformation. T/F

Answer 10

False, there is controversy over this, it is probably something else that turns malignant

Question 11

What is the first thing to do if you find Oral Lichen planus?

Answer 11

Rule out candidiasis

Question 12

How do you treat Erythematous Oral Lichen Planus

Answer 12

Potent Topical steroid “off Label”

Question 13

What is it called when something appears to be lichen planus but is caused by something else?

Answer 13

lichenoid—amalgam reaction, drug reaction, mucositis etc

Question 14

Most common collagen vascular/connective tissue disease in U.S.

Answer 14

Lupus erythematosus

Question 15

what are the 3 forms of Lupus Erythematous

Answer 15

Chronic Cutaneous Lupus Erythematous, Systemic Lupus Erythematosus, Subacute cutaneous lupus erythematosus

Question 16

Clinical Features of Chronic Cutaneous Lupus Erythematosus

Answer 16

Skin-scaly erythematous patches, heal then reappear, scars. Lichenoid mucositis

Question 17

Malar “butterfly rash” is associated with?

Answer 17

Systemic Lupus Erythematosus

Question 18

What are the 2 involvements you should be worries about with systemic lupus?

Answer 18

Renal and cardiac involvement

Question 19

Rare condition characterized by inappropriate deposition of dense collagen

Answer 19

Systemic Sclerosis

Question 20

Hard smooth texture of skin, raynaud phenomenon, sclerodactyly, acro-osteolysis, mask like face, atrophy of alae, mouse facies, dysphagia are all clinical features of what?

Answer 20

Systemic Sclerosis

Question 21

Discoloration of the fingers or toes after exposure to changes in temperature or emotion events

Answer 21

Raynaud’s phenomenon

Question 22

resorption of posterior ramus, diffuse widening of PDL and possibly root resorption are radiographic features of what?

Answer 22

Systemic sclerosis

Question 23

Most deaths of systemic sclerosis are due to what?

Answer 23

deposition of collagen on internal organs

Question 24

Systemic sclerosis prognosis, limited cutaneous involvement is better/worse than diffuse cutaneous involvement

Answer 24

Better

Question 25

What does CREST syndrome stand for?

Answer 25

Calcinosis cutis, Raynaud's phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasia-These are a milder version of systemic sclerosis

Question 26

Is CREST syndrome better or worse than systemic sclerosis?

Answer 26

Better than sclerosis

Question 27

Group of inherited disorders in which two or more ectodermally derived structures do not develop normally or fail to develop

Answer 27

Ectodermal dysplasia

Question 28

Hypohidrotic ectodermal dysplasia is what?

Answer 28

Heat intolerance in ectodermal dysplasia-I'm not actually sure.

Question 29

In what disease do autoantibodies destroy desmosomes?

Answer 29

Pemphigus vulgaris

Question 30

Pemphigus Vulgaris has (oral or body) lesions that are "first to show, last to go"?

Answer 30

Oral

Question 31

What is a nikolsky sign and what does it indicate?

Answer 31

Inducing a bulla by applying firm lateral pressure on skin, indicates Pemphigus Vulgaris

Question 32

which immunofluorescence is used to detect antibodies in tissues?

Answer 32

direct

Question 33

which immunofluorescence is used to detect antibodies in blood?

Answer 33

indirect

Question 34

treatment for pemphigus vulgaris

Answer 34

systemic corticosteroids

Question 35

prognosis of pemphigus vulgaris

Answer 35

prior to therapy, 60-90% mortality, 5-10% after treatment

Question 36

mucous membrane pemphigoid more or less common than pv

Answer 36

more, 2x

Question 37

would you see intraoral intact blisters in mucous membrane pemphigoid or pemphigus vulgaris?

Answer 37

MMP

Question 38

Clinical features of Mucous Membrane pemphigoid

Answer 38

desquamative gingivitis

Question 39

Scarring involvement of the symblepheron in the eye is the most significant aspect of which condition?

Answer 39

Mucous Membrane Pemphigoid

Question 40

Mucous Membrane Pemphigoid is positive or negative DIF and IIF?

Answer 40

Positive DIF and Negative IIF

Question 41

Treatment for Mucous membrane Pemphigoid

Answer 41

Topical steroids-frequent dental prophylaxis and refer to opthalmologist

Question 42

Prognosis for Mucous Membrane Pemphigoid

Answer 42

Rarely fatal, blindness can result

Question 43

What is the most common of autoimmune blistering conditions?

Answer 43

Bullous Pemphigoid

Question 44

Bullous Pemphigoid is positive or negative IIF and DIF

Answer 44

Positive to both

Question 45

Treatment for Bullous Pemphigoid

Answer 45

Usually resolves within 2 years

Question 46

Acute onset of ulcerative disorder skin and mucous membranes

Answer 46

Erythema Multiforme

Question 47

When is erythema multiforme considered major?

Answer 47

2 or more mucosal sites in conjunction with skin lesions

Question 48

Stevens-JOhnson syndrome

Answer 48

at least 2 mucosal sites plus skin involvement (<10%)

Question 49

Toxic epidermal necrolysis

Answer 49

Diffuse bullous involvement of skin and mucosa (>30%)

Question 50

Stevens-Johnson syndrome and Toxic epidermal necrolysis are almost always triggered by what?

Answer 50

a Drug

Question 51

Treatment for EM

Answer 51

Discontinue the problem drug, steroids, analgesics

Question 52

What should be avoided in management of Toxic Epidermal Necrolysis?

Answer 52

Steroids