gingival lesions of systemic origin: Mucocutaneous disorders Flashcards Preview

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Flashcards in gingival lesions of systemic origin: Mucocutaneous disorders Deck (77):
1

what is the most common mucocutaneous disease?

Lichen planus

2

what is the prevalence of lichen planus?

0.1-4%

3

Skin lesions of lichen planus are characterized by papules with white striae, known as ___________

(Wickham striae)

4

_______ is the most common symptom of lichen planus

itching

5

T/F: lichen planus skin lesions disappear after a few months but oral lesions stay for years

true

6

what are the common clinical characteristics of oral lichen planus?

white papules and white striation which often form reticular patterns, usually of bilateral occurrence.

7

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

8

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

9

what lichen planus lesion forms are associated with symptoms?

Atrophic, ulcerative, bullous forms

10

T/F: ular, reticular, plaque-like lesion forms are generally asymptomatic in Lichen plans

true

11

what are the microscopic characteristics of Oral Lichenoid Lesions?

is a subepithelial, band-like accumulation of lymphocytes and macrophages characteristic

12

what causes the accumulation of lymphocytes and macrophages in oral lichnoid lesions?

a type IV hypersensitivity reaction

13

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

14

T/F: Fibrin in the basement membrane, and deposits of IgM, C3, C4, and C5 are characteristic of OLP

true

15

what is a Pemphigoid?

A group of disorders in which autoantibodies migrate towards components of the basement membrane

16

what is the result of pemphigoid?

result in detachment of the epithelium from the connective tissue

17

Pemphigoid is characterized by autoantibody reactions against ________ and __________ components.

hemidesmosome and lamina lucida components.

18

what is benign mucous membrane pemphigoid (BMMP)?

a pemphigoid in which only mucous membrane are affected

19

Cicatricial pemphigoid is also used to describe subepithelial bullous disease limited to the ________ or _______

mouth or eyes

20

what is the main manifestation of BMMP?

desquamative lesions of the gingiva presenting intensely erythematous attached gingiva

21

which type of pemphigoid is associated with scarring?

cicatricial

22

name the 3 types of pemphigoids

- Bullous
- Benign Mucous Membrane
- Cicatricial (Scar formation)

23

what is the "Nicholsky sign"? (related to pemphigoids)

Rubbing of the gingiva creates bulla formation

24

how is BMMP (and other pemphigoids) treated?

Plaque removal with daily use of chlorhexidine and/or topical corticosteroid

25

what are the lesions formed by Pemphigus vulgaris?

Formation of intraepithelial bullae in skin and mucous membranes

26

T/F: Pemphigus vulgaris is strongly related to genetics

TRUE

Jewish and Mediterranean decent

27

what are the physical symptoms of pemphigus vulgaris?

Painful desquamative lesions, erosions or ulcerations.

Chronic course with recurrent bulla formation

28

Acantholysis (due to destruction of desmosomes) is a histological sign for what condition?

pemphigus vulgaris

29

in a patient suffering from pemphigus vulgaris, there will be circulating autoantibodies against ________________

interepithelial adhesion molecules

30

T/F: in pemphigus vulgaris, there will be elevated pericellular epithelial deposits of IgG and C3

true

31

what is Lupus erythematosus?

Autoimmune connective tissue disorders in which autoantibodies form to various CELLULAR constituents

32

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

33

_________ _______ Lesions can be ulcerated and cannot be differentiated from leukoplakia or atrophic oral lichen planus

lupus erythematosus

34

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

35

T/F: lupus erythematosus is associated with degeneration of basal cells and decreased width of the basement membrane

false

Degeneration of basal cells and increased width of the basement membrane

36

the ______ forms of lupus erythematosus can be fatal

systemic

37

what are the 2 major forms of lupus erythematosus?

discoid and systemic

38

the _______ form of lupus erythematosus is the mild chronic form which affects skin and mucous membranes

discoid

39

T/F: antimetabolite drugs used for immunsuppresion in the treatment of autoimmune and other diseases may cause ulcerations

true

40

Swelling, ulceration, petecchia and erythema of gingiva are all found in patients with ________

leukemia

41

_____% of patients with acute leukemia had oral signs of leukemia

69

42

Fibroma/ focal fibrous hyperplasia is due to the _______ processes of periodontal soft tissues

reactive

43

Sessile, well-circumscribed smooth-surfaced nodules are characteristics of what type of lesion?

fibromas & focal fibrous hyperplasia

44

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

45

what is the differential diagnosis of a calcified fibroblastic granuloma?

Pyogenic granuloma

46

what clinical signs are associated with Pyogenic granuloma?

- Ulcerated

- Reddish or bluish, sometimes lobulated, sessile or pedunculated. Bleeding is common

- Highly vascular with chronic inflammatory cells

47

what is a differential diagnosis for pyogenic granulomas?

Pregnancy tumor

48

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
giant cells

- lesions probably originate from the periodontal ligament

49

what is the differential diagnosis for peripheral giant cell granulomas?

focal fibrous hyperplasia

50

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

51

Periapical cemental dysplasia is a ______ process of periodontal ______ tissues

Reactive processes of periodontal hard tissues

52

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

53

what is the differential diagnosis for Periapical cemental dysplasia

Cemento-ossifying fibroma and fibrous dysplasia

54

T/F: 4-5 different types of papillomas can occur

true

55

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

56

what is commonly found inside papilloma lesions?

the Human Papilloma Virus

57

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

58

Peripheral odontogenic tumors are _______ lesions of periodontal soft tissue

benign

59

where are peripheral odontogenic tumors generally found?

Generally detected in the soft tissue around unerupted teeth

60

Ameloblastomas are derived from ____________

odontogenic epithelium

61

T/F: Squamous odontogenic tumors are malignant

false- they are benign

62

Squamous odontogenic tumors are derived from where?

Derived from pdl, presumably from epithelial rests of Malassez

63

A ________________ is a Slow-growing neoplasm forming hard tissue around the apex of a tooth

Benign cementoblastoma

64

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

65

________________ are usually caused by soft tissue metastasis from lung cancer

Metastasis to the gingiva

66

T/F: Most of the metastasis cases are carcinoma and not sarcoma

true

67

there is a reoccurrence of Kaposi’s sarcoma in what population group?

AIDS patients

68

T/F: Primary malignant lymphoma is rare in the oral cavity

true

(only seen in AIDS patients)

69

only ____% of osteosarcomas occur in the jaw

7%

70

Swelling, tenderness, pain and loosening of teeth are frequent symptoms of what malignant condition?

Langerhans cell disease (Histiocytosis X)

71

name the 5 cysts of the periodontium

1- Gingival cyst

2- Lateral periodontal cyst

3- Inflammatory paradental cyst

4- Odontogenic keratocyst

5- Radicular cyst

72

Deposits of C3, IgG and other Ig.s in the basement membranes are found in what condition?

pemphigoids

73

pemphigoids are caused by _____________ reactions

auto-antibody

74

____________-mediated cell destructive processes may be involved in the pathogenesis of pemphigoids

compliment

75

_____________ is the breakdown of the spinous bridges in epithelium

Acantholysis

76

vascular lesions formed by dilatation of a group of small blood vessels is characteristic of what condition?

lupus erythematous

77

Name the condition with the following characteristics:
Periapical bone is replaced by cellular fibroblastic tissue through a cementoblastic phase

Periapical cemental dysplasia