Flashcards in gingival lesions of systemic origin: Mucocutaneous disorders Deck (77):
what is the most common mucocutaneous disease?
what is the prevalence of lichen planus?
Skin lesions of lichen planus are characterized by papules with white striae, known as ___________
_______ is the most common symptom of lichen planus
T/F: lichen planus skin lesions disappear after a few months but oral lesions stay for years
what are the common clinical characteristics of oral lichen planus?
white papules and white striation which often form reticular patterns, usually of bilateral occurrence.
what is a papule? a plaque? a bulla?
Papula= a small, inflammatory, congested spot on the skin; a pimple
Plaque= A patch on the skin or on a mucous surface
Bulla= A large blister or skin vesicle filled with fluid
what is meant when a lesion is described as "reticular"? what about "ulcerative"?
Reticular= Mesh; in the form of network
Ulcerative= Affected with an ulcer; open sore or lesion of the skin or mucosa accompanied by sloughing of inflamed necrotic tissue
what lichen planus lesion forms are associated with symptoms?
Atrophic, ulcerative, bullous forms
T/F: ular, reticular, plaque-like lesion forms are generally asymptomatic in Lichen plans
what are the microscopic characteristics of Oral Lichenoid Lesions?
is a subepithelial, band-like accumulation of lymphocytes and macrophages characteristic
what causes the accumulation of lymphocytes and macrophages in oral lichnoid lesions?
a type IV hypersensitivity reaction
what is the most important part of treating oral lichnoid lesions?
Most of important of part of the treatment is an atraumatic meticulous plaque control
T/F: Fibrin in the basement membrane, and deposits of IgM, C3, C4, and C5 are characteristic of OLP
what is a Pemphigoid?
A group of disorders in which autoantibodies migrate towards components of the basement membrane
what is the result of pemphigoid?
result in detachment of the epithelium from the connective tissue
Pemphigoid is characterized by autoantibody reactions against ________ and __________ components.
hemidesmosome and lamina lucida components.
what is benign mucous membrane pemphigoid (BMMP)?
a pemphigoid in which only mucous membrane are affected
Cicatricial pemphigoid is also used to describe subepithelial bullous disease limited to the ________ or _______
mouth or eyes
what is the main manifestation of BMMP?
desquamative lesions of the gingiva presenting intensely erythematous attached gingiva
which type of pemphigoid is associated with scarring?
name the 3 types of pemphigoids
- Benign Mucous Membrane
- Cicatricial (Scar formation)
what is the "Nicholsky sign"? (related to pemphigoids)
Rubbing of the gingiva creates bulla formation
how is BMMP (and other pemphigoids) treated?
Plaque removal with daily use of chlorhexidine and/or topical corticosteroid
what are the lesions formed by Pemphigus vulgaris?
Formation of intraepithelial bullae in skin and mucous membranes
T/F: Pemphigus vulgaris is strongly related to genetics
Jewish and Mediterranean decent
what are the physical symptoms of pemphigus vulgaris?
Painful desquamative lesions, erosions or ulcerations.
Chronic course with recurrent bulla formation
Acantholysis (due to destruction of desmosomes) is a histological sign for what condition?
in a patient suffering from pemphigus vulgaris, there will be circulating autoantibodies against ________________
interepithelial adhesion molecules
T/F: in pemphigus vulgaris, there will be elevated pericellular epithelial deposits of IgG and C3
what is Lupus erythematosus?
Autoimmune connective tissue disorders in which autoantibodies form to various CELLULAR constituents
what are the characteristics of the lesions formed by Lupus erythematosus?
Central atrophic area with small white dots surrounded by irradiating fine white striae with a periphery of telangiectasia
_________ _______ Lesions can be ulcerated and cannot be differentiated from leukoplakia or atrophic oral lichen planus
what are the histological characteristics of lupus erythematosus?
Degeneration of basal cells and increased WIDTH of the basement membrane.
Deposits of various Ig.s, C3 and FIBRIN along the basement membrane
T/F: lupus erythematosus is associated with degeneration of basal cells and decreased width of the basement membrane
Degeneration of basal cells and increased width of the basement membrane
the ______ forms of lupus erythematosus can be fatal
what are the 2 major forms of lupus erythematosus?
discoid and systemic
the _______ form of lupus erythematosus is the mild chronic form which affects skin and mucous membranes
T/F: antimetabolite drugs used for immunsuppresion in the treatment of autoimmune and other diseases may cause ulcerations
Swelling, ulceration, petecchia and erythema of gingiva are all found in patients with ________
_____% of patients with acute leukemia had oral signs of leukemia
Fibroma/ focal fibrous hyperplasia is due to the _______ processes of periodontal soft tissues
Sessile, well-circumscribed smooth-surfaced nodules are characteristics of what type of lesion?
fibromas & focal fibrous hyperplasia
what are the characteristics of Calcified fibroblastic granulomas?
- Often reddish and ulcerated reactive lesion
- Fibrous proliferation in which bone- or cementum-like hard tissue is formed
- Highly cell-rich areas below ulcerated sites
what is the differential diagnosis of a calcified fibroblastic granuloma?
what clinical signs are associated with Pyogenic granuloma?
- Reddish or bluish, sometimes lobulated, sessile or pedunculated. Bleeding is common
- Highly vascular with chronic inflammatory cells
what is a differential diagnosis for pyogenic granulomas?
characteristics of Peripheral giant cell granulomas:
- can occur anywhere on the gingival mucosa
- Pedunculated (has a stalk), sessile (broad base),
red or purple, commonly ulcerated
- Focal collection of multi-nucleated osteoclast-like
- lesions probably originate from the periodontal ligament
what is the differential diagnosis for peripheral giant cell granulomas?
focal fibrous hyperplasia
name all the periodontal tumors associated with REACTIVE processes of periodontal SOFT tissues:
1) Fibroma/ focal fibrous hyperplasia
2) Calcified fibroblastic granuloma
3) Pyogenic granuloma
4) Peripheral giant cell granuloma
Periapical cemental dysplasia is a ______ process of periodontal ______ tissues
Reactive processes of periodontal hard tissues
characteristics of periapical cemental dysplasia:
- Fibrous-osseous cemental lesions
- Tooth is usually vital.
- Usually no symptoms
- Periapical bone is replaced by cellular fibroblastic tissue through a cementoblastic phase
what is the differential diagnosis for Periapical cemental dysplasia
Cemento-ossifying fibroma and fibrous dysplasia
T/F: 4-5 different types of papillomas can occur
what are the physical characteristics of papillomas?
Exophytic, pedunculated or sessile lesions. Reddish/normal or whitish/gray color
A granular/moruloid or filiform/digitated surface
what is commonly found inside papilloma lesions?
the Human Papilloma Virus
characteristics of Verruca vulgaris (a type of papilloma)
- less common in oral mucosa compared to skin
- Sessile, exophytic or raised lesion with a whitish surface
- Papillomatous surface with hyperkeratinization
and elongated rete ridges
Peripheral odontogenic tumors are _______ lesions of periodontal soft tissue
where are peripheral odontogenic tumors generally found?
Generally detected in the soft tissue around unerupted teeth
Ameloblastomas are derived from ____________
T/F: Squamous odontogenic tumors are malignant
false- they are benign
Squamous odontogenic tumors are derived from where?
Derived from pdl, presumably from epithelial rests of Malassez
A ________________ is a Slow-growing neoplasm forming hard tissue around the apex of a tooth
what are the general characteristics of Squamous cell carcinomas?
- found in mandible, posterior to the premolars
- nodular lesions, often with ulceration and surrounding leukoplakia
- Regional lymph-node metastasis is common
________________ are usually caused by soft tissue metastasis from lung cancer
Metastasis to the gingiva
T/F: Most of the metastasis cases are carcinoma and not sarcoma
there is a reoccurrence of Kaposi’s sarcoma in what population group?
T/F: Primary malignant lymphoma is rare in the oral cavity
(only seen in AIDS patients)
only ____% of osteosarcomas occur in the jaw
Swelling, tenderness, pain and loosening of teeth are frequent symptoms of what malignant condition?
Langerhans cell disease (Histiocytosis X)
name the 5 cysts of the periodontium
1- Gingival cyst
2- Lateral periodontal cyst
3- Inflammatory paradental cyst
4- Odontogenic keratocyst
5- Radicular cyst
Deposits of C3, IgG and other Ig.s in the basement membranes are found in what condition?
pemphigoids are caused by _____________ reactions
____________-mediated cell destructive processes may be involved in the pathogenesis of pemphigoids
_____________ is the breakdown of the spinous bridges in epithelium
vascular lesions formed by dilatation of a group of small blood vessels is characteristic of what condition?