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Questions and Answers
Which disease is characterized by specific lgG antibodies binding to an antigen on intercellular desmosomes of the epithelium?
Which disease is characterized by specific lgG antibodies binding to an antigen on intercellular desmosomes of the epithelium?
Which viral infection can manifest as vesicular lesions in the oral cavity?
Which viral infection can manifest as vesicular lesions in the oral cavity?
Which disease is characterized by intraepidermal or intraepithelial vesicle or bulla formation?
Which disease is characterized by intraepidermal or intraepithelial vesicle or bulla formation?
Which disease frequently appears first in the oral cavity and can progress to involve other sites?
Which disease frequently appears first in the oral cavity and can progress to involve other sites?
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What is the clinical diagnosis based on the description provided?
What is the clinical diagnosis based on the description provided?
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What is the result of the Tzanck smear test?
What is the result of the Tzanck smear test?
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What is advised as a part of the topical treatment?
What is advised as a part of the topical treatment?
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What is recommended for systemic treatment?
What is recommended for systemic treatment?
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Which pemphigus disease presents with thin-walled bullae on noninflamed base and positive Nikolsky sign?
Which pemphigus disease presents with thin-walled bullae on noninflamed base and positive Nikolsky sign?
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What is a common differential diagnosis for Mucous Membrane Pemphigoid?
What is a common differential diagnosis for Mucous Membrane Pemphigoid?
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What is a characteristic of Bullous Pemphigoid?
What is a characteristic of Bullous Pemphigoid?
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What are the common sites affected by Mucous Membrane Pemphigoid?
What are the common sites affected by Mucous Membrane Pemphigoid?
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Which lab test is characteristic for Pemphigus Vulgaris?
Which lab test is characteristic for Pemphigus Vulgaris?
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What is a common treatment option for Mucous Membrane Pemphigoid?
What is a common treatment option for Mucous Membrane Pemphigoid?
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What age group is primarily affected by Bullous Pemphigoid?
What age group is primarily affected by Bullous Pemphigoid?
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What is a characteristic of the lab tests for Mucous Membrane Pemphigoid?
What is a characteristic of the lab tests for Mucous Membrane Pemphigoid?
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What is a key manifestation of Bullous Pemphigoid?
What is a key manifestation of Bullous Pemphigoid?
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What is a common differential diagnosis for Pemphigus Vulgaris?
What is a common differential diagnosis for Pemphigus Vulgaris?
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What is a common differential diagnosis for Bullous Pemphigoid?
What is a common differential diagnosis for Bullous Pemphigoid?
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What is the gender predilection for Dermatitis Herpetiformis?
What is the gender predilection for Dermatitis Herpetiformis?
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Which age group is Dermatitis Herpetiformis more common in?
Which age group is Dermatitis Herpetiformis more common in?
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Where are the lesions of Dermatitis Herpetiformis usually symmetrically distributed?
Where are the lesions of Dermatitis Herpetiformis usually symmetrically distributed?
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What is the association of Dermatitis Herpetiformis with gluten-sensitive enteropathy?
What is the association of Dermatitis Herpetiformis with gluten-sensitive enteropathy?
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Which disease is nearly always drug-related?
Which disease is nearly always drug-related?
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What is the classic skin lesion of Erythema Multiforme?
What is the classic skin lesion of Erythema Multiforme?
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What is the microscopic pattern of Erythema Multiforme characterized by?
What is the microscopic pattern of Erythema Multiforme characterized by?
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What is the recommended treatment for Erythema Multiforme major?
What is the recommended treatment for Erythema Multiforme major?
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What is a common prodromal symptom of Stevens-Johnson Syndrome?
What is a common prodromal symptom of Stevens-Johnson Syndrome?
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Which disease involves extensive formation of vesicles or bullae in the oral mucosa?
Which disease involves extensive formation of vesicles or bullae in the oral mucosa?
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What is the characteristic feature of the oral lesions in Erythema Multiforme?
What is the characteristic feature of the oral lesions in Erythema Multiforme?
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What is the primary treatment for Erythema Multiforme minor?
What is the primary treatment for Erythema Multiforme minor?
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What is a key manifestation of Stevens-Johnson Syndrome?
What is a key manifestation of Stevens-Johnson Syndrome?
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What is the recommended approach for Stevens-Johnson Syndrome treatment?
What is the recommended approach for Stevens-Johnson Syndrome treatment?
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What is the characteristic histopathologic examination finding for Stevens-Johnson Syndrome?
What is the characteristic histopathologic examination finding for Stevens-Johnson Syndrome?
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What is the most common cutaneous manifestation of Erythema Multiforme?
What is the most common cutaneous manifestation of Erythema Multiforme?
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What is the most effective treatment for oral ulcers in Behçet’s disease?
What is the most effective treatment for oral ulcers in Behçet’s disease?
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What is the main treatment for Behçet’s disease?
What is the main treatment for Behçet’s disease?
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What is the significance of a positive pathergy test in Behçet’s disease?
What is the significance of a positive pathergy test in Behçet’s disease?
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Which patients tend to have a positive skin-prick test for Behçet’s disease?
Which patients tend to have a positive skin-prick test for Behçet’s disease?
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What is a promising recent option for the treatment of Behçet’s disease?
What is a promising recent option for the treatment of Behçet’s disease?
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What are the complications associated with Behçet’s disease?
What are the complications associated with Behçet’s disease?
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What is the role of steroids in the treatment of Behçet’s disease?
What is the role of steroids in the treatment of Behçet’s disease?
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What is the significance of a positive skin-prick test in Behçet’s disease?
What is the significance of a positive skin-prick test in Behçet’s disease?
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What is the effect of a positive skin-prick test in Behçet’s disease?
What is the effect of a positive skin-prick test in Behçet’s disease?
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What is the recommended approach for the treatment of Behçet’s disease?
What is the recommended approach for the treatment of Behçet’s disease?
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Which condition presents with a symmetric, asymptomatic, gray-white, diffuse, milky surface with an opalescent quality on the buccal mucosa?
Which condition presents with a symmetric, asymptomatic, gray-white, diffuse, milky surface with an opalescent quality on the buccal mucosa?
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Which condition's clinical recognition is usually sufficient for diagnosis, and no treatment is required?
Which condition's clinical recognition is usually sufficient for diagnosis, and no treatment is required?
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Which condition's etiology is essentially unknown, but many cases are related to the use of tobacco?
Which condition's etiology is essentially unknown, but many cases are related to the use of tobacco?
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Which condition has clinical subsets including homogeneous, verrucous, speckled, and proliferative verrucous leukoplakia?
Which condition has clinical subsets including homogeneous, verrucous, speckled, and proliferative verrucous leukoplakia?
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Which condition has an increased risk of dysplasia or carcinoma when occurring on the tongue, floor of the mouth, or vermilion portion of the lip?
Which condition has an increased risk of dysplasia or carcinoma when occurring on the tongue, floor of the mouth, or vermilion portion of the lip?
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Which condition has a white (sometimes white-and-red) patch and may progress to dysplasia or malignancy?
Which condition has a white (sometimes white-and-red) patch and may progress to dysplasia or malignancy?
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Which condition is characterized by a white appearance that disappears with stretching of the mucosa?
Which condition is characterized by a white appearance that disappears with stretching of the mucosa?
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Which condition's prognosis is excellent, and no treatment is required?
Which condition's prognosis is excellent, and no treatment is required?
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Which condition is irreversible and the treatment consists of local steroid injection and surgical disruption (lysis) of fibrous bands, however, outcomes are generally poor?
Which condition is irreversible and the treatment consists of local steroid injection and surgical disruption (lysis) of fibrous bands, however, outcomes are generally poor?
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Which disease has a hereditary (autosomal-dominant) disorder of keratinization affecting nonkeratinizing oral, esophageal, and anogenital mucosal epithelium?
Which disease has a hereditary (autosomal-dominant) disorder of keratinization affecting nonkeratinizing oral, esophageal, and anogenital mucosal epithelium?
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Which disease is usually seen in men in Western countries and presents as a mucosal pouch with a soft, white, fissured appearance due to chronic tobacco use over many years?
Which disease is usually seen in men in Western countries and presents as a mucosal pouch with a soft, white, fissured appearance due to chronic tobacco use over many years?
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Which disease is often seen in edentulous areas of the alveolar ridge, but may also be observed in other parts of the oral mucosa exposed to increased friction or trauma?
Which disease is often seen in edentulous areas of the alveolar ridge, but may also be observed in other parts of the oral mucosa exposed to increased friction or trauma?
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Which condition's clinical appearance usually commences during adolescence and is characterized by deeply folded, thickened, white mucosa chiefly affecting the buccal mucosa?
Which condition's clinical appearance usually commences during adolescence and is characterized by deeply folded, thickened, white mucosa chiefly affecting the buccal mucosa?
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Which disease's etiology results from direct mucosal contact with a quid containing areca (betel) nut, tobacco, and other ingredients?
Which disease's etiology results from direct mucosal contact with a quid containing areca (betel) nut, tobacco, and other ingredients?
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Which condition is characterized by a white, keratotic surface and is often seen in edentulous areas of the alveolar ridge?
Which condition is characterized by a white, keratotic surface and is often seen in edentulous areas of the alveolar ridge?
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Which disease's clinical presentation includes mucosal rigidity, trismus, and leukoplakia of the surface with pallor?
Which disease's clinical presentation includes mucosal rigidity, trismus, and leukoplakia of the surface with pallor?
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Which condition's treatment usually involves local steroid injection and surgical disruption (lysis) of fibrous bands, with generally poor outcomes?
Which condition's treatment usually involves local steroid injection and surgical disruption (lysis) of fibrous bands, with generally poor outcomes?
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Which disease's clinical appearance usually presents as a mucosal pouch with a soft, white, fissured appearance and is often seen in men in Western countries?
Which disease's clinical appearance usually presents as a mucosal pouch with a soft, white, fissured appearance and is often seen in men in Western countries?
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What is the characteristic color change when pressure is applied to both vascular malformations and congenital hemangiomas?
What is the characteristic color change when pressure is applied to both vascular malformations and congenital hemangiomas?
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Where can vascular malformations and congenital hemangiomas be found in the oral cavity?
Where can vascular malformations and congenital hemangiomas be found in the oral cavity?
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What is the characteristic appearance of purplish-red, solitary or multiple vascular malformations?
What is the characteristic appearance of purplish-red, solitary or multiple vascular malformations?
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What syndrome is associated with the presence of vascular malformations in the cerebral cortex and in one or more of the facial areas innervated by the trigeminal nerve?
What syndrome is associated with the presence of vascular malformations in the cerebral cortex and in one or more of the facial areas innervated by the trigeminal nerve?
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What is the most common causative factor for Erythema Multiforme?
What is the most common causative factor for Erythema Multiforme?
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Which condition is characterized by a brown-black hemorrhagic crust on the lips?
Which condition is characterized by a brown-black hemorrhagic crust on the lips?
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What is the most frequent and persistent complaint in undiagnosed cases of Systemic lupus erythematosus?
What is the most frequent and persistent complaint in undiagnosed cases of Systemic lupus erythematosus?
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What is the characteristic skin manifestation of chronic discoid lupus erythematosus?
What is the characteristic skin manifestation of chronic discoid lupus erythematosus?
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What is the most important problem with high doses of systemic steroids in patients with chronic discoid lupus erythematosus?
What is the most important problem with high doses of systemic steroids in patients with chronic discoid lupus erythematosus?
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What can cause petechiae and ecchymoses in the mouth?
What can cause petechiae and ecchymoses in the mouth?
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What is the result of blood leaking into the surrounding connective tissue?
What is the result of blood leaking into the surrounding connective tissue?
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What is the first sign of blood diseases that can be seen in the mouth?
What is the first sign of blood diseases that can be seen in the mouth?
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What is the primary treatment for petechiae and ecchymoses in the mouth caused by blood disorders?
What is the primary treatment for petechiae and ecchymoses in the mouth caused by blood disorders?
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What is the most common cause of death in patients with systemic lupus?
What is the most common cause of death in patients with systemic lupus?
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What is the characteristic microscopic pattern of Erythema Multiforme?
What is the characteristic microscopic pattern of Erythema Multiforme?
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What is the recommended treatment for chronic discoid lupus erythematosus?
What is the recommended treatment for chronic discoid lupus erythematosus?
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Which condition is more likely to be premalignant or malignant than leukoplakia, especially in individuals between 50-70 years of age?
Which condition is more likely to be premalignant or malignant than leukoplakia, especially in individuals between 50-70 years of age?
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What is a rare hyperplastic connective tissue response, more common in women over 20 years of age, often found in the gingiva between the 1st molars and incisors?
What is a rare hyperplastic connective tissue response, more common in women over 20 years of age, often found in the gingiva between the 1st molars and incisors?
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Which disease presents as red-brown on the skin or red-blue in the oral mucosa and can be flat or nodular in shape, common in patients with AIDS?
Which disease presents as red-brown on the skin or red-blue in the oral mucosa and can be flat or nodular in shape, common in patients with AIDS?
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What refers to a red patch on oral mucous membranes and is clinically divided into homogeneous and speckled forms?
What refers to a red patch on oral mucous membranes and is clinically divided into homogeneous and speckled forms?
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Which condition consists of hyperplastic granulation tissue, often occurs in the gingiva and is more common in women?
Which condition consists of hyperplastic granulation tissue, often occurs in the gingiva and is more common in women?
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What is a rare autosomal dominant disorder characterized by abnormal vascular dilatations in skin, mucous membranes, and visceral organs, with red macules or papules as lesions?
What is a rare autosomal dominant disorder characterized by abnormal vascular dilatations in skin, mucous membranes, and visceral organs, with red macules or papules as lesions?
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What is characterized by bluish-red dilated veins, are common, especially in the elderly, and can be found on the tongue and lower lip, turning white under pressure?
What is characterized by bluish-red dilated veins, are common, especially in the elderly, and can be found on the tongue and lower lip, turning white under pressure?
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What is more common in women and often found in the gingiva between the 1st molars and incisors?
What is more common in women and often found in the gingiva between the 1st molars and incisors?
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What is more common, especially in the elderly, and can be found on the tongue and lower lip, turning white under pressure?
What is more common, especially in the elderly, and can be found on the tongue and lower lip, turning white under pressure?
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What is a red-brown on the skin or red-blue in the oral mucosa and can be flat or nodular in shape, common in patients with AIDS?
What is a red-brown on the skin or red-blue in the oral mucosa and can be flat or nodular in shape, common in patients with AIDS?
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Which condition is characterized by a brown-black hemorrhagic crust on the lips?
Which condition is characterized by a brown-black hemorrhagic crust on the lips?
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What is the characteristic color change when pressure is applied to both vascular malformations and congenital hemangiomas?
What is the characteristic color change when pressure is applied to both vascular malformations and congenital hemangiomas?
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What is the microscopic pattern of Erythema Multiforme characterized by?
What is the microscopic pattern of Erythema Multiforme characterized by?
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Which viral infection can manifest as vesicular lesions in the oral cavity?
Which viral infection can manifest as vesicular lesions in the oral cavity?
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Where do maxillary tori most commonly develop?
Where do maxillary tori most commonly develop?
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What is the recommended approach for managing irritated or ulcerated covering mucosa of tori?
What is the recommended approach for managing irritated or ulcerated covering mucosa of tori?
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In what situation can tori be surgically removed?
In what situation can tori be surgically removed?
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What is the characteristic location of mandibular tori?
What is the characteristic location of mandibular tori?
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What are exostoses clinically identical to?
What are exostoses clinically identical to?
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Which condition can result in problems with infant feeding and speech development?
Which condition can result in problems with infant feeding and speech development?
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What can high insertion of the maxillary frenulum onto the gingiva lead to?
What can high insertion of the maxillary frenulum onto the gingiva lead to?
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In what age group are tori and exostoses typically identified?
In what age group are tori and exostoses typically identified?
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Which condition's clinical recognition is usually sufficient for diagnosis, and no treatment is required?
Which condition's clinical recognition is usually sufficient for diagnosis, and no treatment is required?
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What is the characteristic feature of the oral lesions in Erythema Multiforme?
What is the characteristic feature of the oral lesions in Erythema Multiforme?
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Where can vascular malformations and congenital hemangiomas be found in the oral cavity?
Where can vascular malformations and congenital hemangiomas be found in the oral cavity?
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What is the result of the Tzanck smear test?
What is the result of the Tzanck smear test?
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What is the most important problem with high doses of systemic steroids in patients with chronic discoid lupus erythematosus?
What is the most important problem with high doses of systemic steroids in patients with chronic discoid lupus erythematosus?
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What is a common differential diagnosis for Mucous Membrane Pemphigoid?
What is a common differential diagnosis for Mucous Membrane Pemphigoid?
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What is the recommended treatment for chronic discoid lupus erythematosus?
What is the recommended treatment for chronic discoid lupus erythematosus?
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Which condition's prognosis is excellent, and no treatment is required?
Which condition's prognosis is excellent, and no treatment is required?
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What is the role of steroids in the treatment of Behçet’s disease?
What is the role of steroids in the treatment of Behçet’s disease?
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What is the recommended treatment for Erythema Multiforme major?
What is the recommended treatment for Erythema Multiforme major?
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Which condition has an increased risk of dysplasia or carcinoma when occurring on the tongue, floor of the mouth, or vermilion portion of the lip?
Which condition has an increased risk of dysplasia or carcinoma when occurring on the tongue, floor of the mouth, or vermilion portion of the lip?
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Which condition's etiology is essentially unknown, but many cases are related to the use of tobacco?
Which condition's etiology is essentially unknown, but many cases are related to the use of tobacco?
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Study Notes
Pemphigus Vulgaris, Mucous Membrane Pemphigoid, and Bullous Pemphigoid: Clinical Manifestations and Diagnosis
- Pemphigus Vulgaris: Presents with thin-walled bullae on noninflamed base, positive Nikolsky sign, and oral lesions in 60% of cases.
- Pemphigus Vulgaris: Lab tests include biopsy showing acantholysis, positive Tzanck smears, and indirect/direct immunofluorescent antibody tests for specific IgG.
- Pemphigus Vulgaris: Differential diagnosis includes acute viral infection, erythema multiforme, and recurrent aphthous stomatitis.
- Pemphigus Vulgaris: Treatment involves early diagnosis and a combination of corticosteroids and immunosuppressive drugs.
- Mucous Membrane Pemphigoid: Affects mucous membranes primarily, with skin involvement in 5-10% of cases.
- Mucous Membrane Pemphigoid: Age over 50 years, female:male ratio 2:1, and sites commonly affected include gingival, buccal mucosa, palate, conjunctiva, and skin.
- Mucous Membrane Pemphigoid: Lab tests show no acantholysis in biopsy, negative Tzanck smears, and positive indirect/direct immunofluorescent antibody tests.
- Mucous Membrane Pemphigoid: Differential diagnosis includes pemphigus vulgaris, bullous pemphigoid, erythema multiforme, and lichen planus.
- Mucous Membrane Pemphigoid: Treatment involves early diagnosis and various options based on disease severity, including topical or systemic corticosteroids and immunosuppressive drugs.
- Bullous Pemphigoid: Characterized by autoantibodies against bullous pemphigoid antigens, affecting older individuals, with cutaneous and oral manifestations.
- Bullous Pemphigoid: Presents with intensely pruritic, erythematous, urticarial-like plaques, tense bullae, and multiform oral lesions.
- Bullous Pemphigoid: Differential diagnosis includes erosive lichen planus, and skin lesions commonly occur on the scalp and limbs.
Oral Lesions and Complications: A Detailed Overview
- Hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease) is a rare autosomal dominant disorder characterized by abnormal vascular dilatations in skin, mucous membranes, and visceral organs, with red macules or papules as lesions.
- Venous varices, characterized by bluish-red dilated veins, are common, especially in the elderly, and can be found on the tongue and lower lip, turning white under pressure.
- Diagnosis of hereditary hemorrhagic telangiectasia is typically based on clinical examination, with angiography being useful for diagnosis and treatment planning. Lesions within the bone in the maxilla and mandible may exhibit a honeycomb appearance.
- Treatment for hereditary hemorrhagic telangiectasia may involve stabilization or regression in early childhood, and options such as selective embolization, sclerosing therapy, and laser therapy.
- Pyogenic granuloma, consisting of hyperplastic granulation tissue, often occurs in the gingiva and is more common in women. Chronic irritation and hormonal changes during pregnancy are common etiological factors.
- Peripheral giant cell granuloma is a rare hyperplastic connective tissue response, more common in women over 20 years of age, often found in the gingiva between the 1st molars and incisors. Diagnosis is made by biopsy, and treatment involves excision.
- Erythroplakia refers to a red patch on oral mucous membranes and is clinically divided into homogeneous and speckled forms. It is more likely to be premalignant or malignant than leukoplakia, especially in individuals between 50-70 years of age. Diagnosis is by biopsy, and treatment involves excision.
- Kaposi sarcoma, common in patients with AIDS, presents as red-brown on the skin or red-blue in the oral mucosa and can be flat or nodular in shape. Diagnosis is by biopsy, and treatment may involve surgical treatment, low-dose radiotherapy, or chemotherapy.
- Drug reactions in the oral cavity can result from systemic or local contact with an allergen. Contact stomatitis can occur due to reactions to cosmetics, toothpaste, gums, antibiotic mouthwashes, or dental restorations.
- Allergic stomatitis of systemic origin can be due to medication or food, resulting in red, swollen, cracked, or dry lips, and gingival redness and edema. Diagnosis involves anamnesis of contact with the allergen, biopsy, and response to treatment.
- Allergies can be classified as early (six hours) and delayed (forty-eight hours) reactions, and may manifest as erythema multiforme, lichenoid eruptions, angioedema, or vesiculobullous eruptions.
- Diagnosis of allergies may involve skin testing, medical history, and elimination diets to identify the allergen
Variants of Normal and Common Benign Conditions in Oral Soft Tissues
- Interdental papillae are affected to varying degrees, while nonkeratinized mucosa remains entirely unaffected.
- Physiologic pigmentation may intensify in areas of chronic trauma or inflammation, such as along the occlusal bite line of the buccal mucosa.
- Occasionally, a biopsy may be necessary to rule out melanoma, especially if changes in size, shape, or pigmentation are noted, or if a flat lesion becomes raised.
- Fordyce granules are sebaceous glands that appear white to yellow in color, generally presenting in clusters and may be slightly raised.
- Gingival grafts, harvested from the patient's palate, are raised and pale, easily recognizable and should not be mistaken for pathology.
- Fissured tongue is often asymptomatic but can become noticeable following the onset of unrelated symptoms, such as burning mouth syndrome.
- Geographic tongue is an inflammatory condition with a map-like appearance and can change daily, rarely requiring biopsy.
- Stomatitis erythema migrans can affect various oral mucosal sites, presenting as subtle circular lesions with white borders.
- Fibromas, the most encountered oral soft tissue lesions, are firm, exophytic, and generally asymptomatic, but may become bothersome due to repetitive trauma.
- Surgical excision is the treatment for fibromas, with no malignant potential but should be excised if the clinical diagnosis is uncertain.
- Tori and exostoses are benign bony growths, with tori specific to the midline hard palate and anterolateral lingual mandible, and exostoses involving the buccal aspect of the maxilla or mandible.
- Tori and exostoses can be mistaken for mucosal growths and are covered by either keratinized or nonkeratinized mucosa, depending on their location.
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Description
Test your knowledge on the clinical manifestations and diagnosis of Pemphigus Vulgaris, Mucous Membrane Pemphigoid, and Bullous Pemphigoid. Explore the distinguishing features, lab tests, differential diagnoses, and treatment options for these autoimmune blistering diseases affecting the skin and mucous membranes.
