Cicatricial Pemphigoid Antigenic Determinants

What is the term used to describe a peculiar condition characterized by intense erythema, desquamation, and ulceration of the free and attached gingiva?

In what percentage of desquamative gingivitis cases is the condition localized to the gingiva?

At what age may desquamative gingivitis occur as early as?

What was initially suspected as the cause of chronic desquamative gingivitis?

What should a dentist be able to do with regards to referring a patient with desquamative gingivitis?

What range of complaints do patients with chronic desquamative gingivitis have, according to the text?

What is the most common dermatologic cause of desquamative gingivitis?

Which of the following autoimmune conditions can clinically manifest as desquamative gingivitis?

Which type of biopsy is considered the best alternative for evaluating desquamative gingivitis?

What is the role of direct immunofluorescence in diagnosing desquamative gingivitis?

In which scenario does the patient require immediate referral to a dermatologist for further evaluation and treatment?

What is the estimated prevalence of oral lichen planus in the population?

Which type of oral lichen planus lesions are asymptomatic, bilateral, and consist of interlacing white lines on the posterior region of the buccal mucosa?

What feature is associated with coexisting candidiasis in reticular lesions of oral lichen planus?

In oral lichen planus, what do atrophic lesions of the gingival tissues result in?

What is the characteristic feature revealed by direct immunofluorescence of oral lichen planus biopsy specimens?

What is the primary treatment for bullous pemphigoid, an autoimmune subepidermal bullous disease?

Which term is preferred for bullous pemphigoid when the disease is nonscarring and mainly affects the skin?

Which therapy is used for patients not responsive to corticosteroids?

What is the primary treatment for Linear Immunoglobulin A Disease (LAD)?

Which condition usually develops in young adults between the ages of 20 and 30 years, and has a slight predilection for men?

Which medication is aimed at the removal of desmoglein-reactive autoantibodies in the treatment of pemphigus vulgaris?

What is the characteristic presentation of Linear Immunoglobulin A Disease (LAD) on the skin?

What is the first-line pharmacologic therapy for chronic ulcerative stomatitis?

Which of the following is the main immunoreactant found in biopsy tests by direct immunofluorescence in mucous membrane pemphigoid?

What is the most characteristic feature of oral involvement in cicatricial pemphigoid?

Which gene codes for pemphigus vulgaris?

Which of the following is the main therapy for pemphigus vulgaris?

What is the worldwide incidence of pemphigus vulgaris per year per 100,000 individuals?

Which of the following is associated with elevated levels of desmoglein 1 (Dsg1) autoantibodies?

Which autoimmune disease is characterized by three different clinical presentations?

What is the classic cutaneous lesion characterized by the presence of a rash on the malar area with a butterfly distribution?

What is the hallmark of erythema multiforme?

What type of lupus erythematosus usually has no systemic signs or symptoms?

What type of lupus erythematosus presents cutaneous lesions similar to DLE but lacks the development of scarring and atrophy?

What autoimmune disease has anti-endomysial and gliadin antibodies in almost 80% of patients?

Which of the following conditions is treated with a gluten-free diet?

What is believed to be the genesis of the mucocutaneous lesions in erythema multiforme?

What is an underdiagnosed type of erythema multiforme?

What is the drug of choice for patients with bullous or ulcerative lesions and severe symptoms of erythema multiforme?

What term was coined in 1932 to describe a peculiar condition characterized by intense erythema, desquamation, and ulceration of the free and attached gingiva?

What percentage of desquamative gingivitis cases are localized to the gingiva?

What was initially suspected as the cause of chronic desquamative gingivitis?

What is the characteristic feature of oral involvement in cicatricial pemphigoid?

What is the estimated prevalence of oral lichen planus in the population?

What type of lupus erythematosus presents cutaneous lesions similar to discoid lupus erythematosus (DLE) but lacks the development of scarring and atrophy?

What are the typical reticular lesions of oral lichen planus composed of, and where are they located?

What is the primary treatment for bullous pemphigoid, an autoimmune subepidermal bullous disease?

What is the characteristic feature revealed by direct immunofluorescence of oral lichen planus biopsy specimens?

What are the distinctive patterns of gingival lesions that may occur in patients with oral lichen planus?

What are the clinical findings that are probably the best cognitive element to use to discriminate between bullous pemphigoid and mucous membrane pemphigoid?

What is the term preferred for bullous pemphigoid when the disease is nonscarring and mainly affects the skin?

What is the most common antigenic determinant associated with cicatricial pemphigoid?

In patients with pemphigus vulgaris, what do high levels of desmoglein 3 (Dsg3) autoantibodies correlate with?

What are the main immunoreactants found in biopsy tests by direct immunofluorescence in mucous membrane pemphigoid?

What is the primary therapy for pemphigus vulgaris?

What is the term used to describe the characteristic intraepithelial clefting at the basal–spinous cell layers and interface with acantholysis seen in pemphigus vulgaris?

What is the estimated worldwide incidence of pemphigus vulgaris per year per 100,000 individuals?

What is the suggested approach to establish an accurate final diagnosis of desquamative gingivitis?

What clinical maneuver offers insight into the plausibility of the presence of a vesiculobullous disorder?

What type of biopsy is the best alternative to begin the microscopic and immunologic evaluation given the extent and number of lesions present in an individual?

What is the term used to describe a peculiar condition characterized by intense erythema, desquamation, and ulceration of the free and attached gingiva?

In what percentage of desquamative gingivitis cases does desquamative gingivitis have a dermatologic genesis?

What is the classic example of a condition that requires collaboration between a dentist and another health care provider for evaluation and treatment?

What is the primary treatment for severe cases of chronic ulcerative stomatitis?

What is the primary treatment for Linear Immunoglobulin A Disease (LAD), and what can be added if the initial response is inadequate?

What is the main therapy for pemphigus vulgaris, and what is currently being evaluated as an adjunct to treat it?

What is the characteristic presentation of chronic ulcerative stomatitis on the oral mucosa?

What is the characteristic presentation of Linear Immunoglobulin A Disease (LAD) on the skin?

What is the primary treatment for dermatitis herpetiformis, and what is it believed to be a cutaneous manifestation of?

What is the primary treatment for dermatitis herpetiformis?

What are the three different clinical presentations of lupus erythematosus?

What is the hallmark of erythema multiforme?

What is the term used to describe the skin lesions in chronic cutaneous lupus erythematosus?

What is the worldwide incidence of pemphigus vulgaris per year per 100,000 individuals?

What is the local reaction from the use of a medicament in the oral cavity referred to as?

What is the characteristic feature of drug eruptions in the oral cavity?

What are the main immunoreactants found in biopsy tests by direct immunofluorescence in mucous membrane pemphigoid?

What is the characteristic feature revealed by direct immunofluorescence of oral lichen planus biopsy specimens?

What is the estimated prevalence of erythema multiforme in the population?

Desquamative gingivitis is not a specific disease entity but rather a gingival response associated with a variety of ______

Cicatricial pemphigoid and lichen planus account for more than 95% of the dermatologic ______

Other conditions that may clinically manifest as desquamative gingivitis include bullous pemphigoid, pemphigus vulgaris, linear immunoglobulin A [IgA] disease, dermatitis herpetiformis, lupus erythematosus, and chronic ulcerative ______

Desquamative gingivitis is only a clinical term and not a diagnosis per ______

Given the extent and number of lesions that may be present in an individual, an incisional biopsy is the best alternative to use to begin the microscopic and ______ evaluation

After the diagnosis is established, the dentist must choose the optimum management for the patient in accordance with three factors: the practitioner’s experience, the systemic impact of the disease, and the systemic complications of the ______

The typical reticular lesions of oral lichen planus are asymptomatic and bilateral, and they consist of interlacing white lines on the posterior region of the buccal ______.

Approximately 7% to 10% of patients with oral lichen planus have lesions restricted to the ______ tissue.

Bullous pemphigoid is a chronic, autoimmune, subepidermal bullous disease with tense cutaneous ______ that rupture and become flaccid.

The primary treatment for bullous pemphigoid is a moderate dose of systemic ______.

Mucous membrane pemphigoid involves the oral cavity, the conjunctiva, and the mucosa of the nose, vagina, rectum, esophagus, and ______.

In about 20% of patients, the skin may also be involved in mucous membrane pemphigoid, which is also known as ______ pemphigoid.

Prof. Dr. TOLGA TOZUM YAKINDOĞU ÜNİVERSİTESİ DİŞHEKİMLİĞİ FAKÜLTESİ Learning outcomes: 1- Will be able to describes diseases and conditions that are seen in with ______ gingivitis.

Patients may be asymptomatic; when symptomatic, however, their complaints range from a mild burning sensation to an intense ______.

Approximately 50% of desquamative gingivitis cases are localized to the ______, although patients can have involvement of the gingiva plus other intraoral and even extraoral sites.

Although first recognized and reported in 1894,157 the term chronic desquamative gingivitis was coined in 1932 by Prinz122 to describe a peculiar condition characterized by intense erythema, desquamation, and ulceration of the free and attached ______.

Because most cases were diagnosed in women during the fourth and fifth decades of life (although desquamative gingivitis may occur as early as puberty or as late as the seventh or eighth decade), a hormonal ______ was suspected.

Initially, the cause of this condition was unclear, with a variety of ______ suggested.

Pemphigus vulgaris is a potentially lethal chronic condition with a 10% mortality rate and a worldwide incidence of 0.1 to 0.5 cases per year per 100,000 individuals. A predilection in women, usually after the fourth decade of life, has been observed. However, pemphigus vulgaris has also been reported in unusually young children and even in ______.

The epidermal and mucous membrane blisters occur when the cell-to-cell adhesion structures are damaged by the action of circulating autoantibodies and by the in vivo binding of these autoantibodies to the pemphigus vulgaris antigens, which are cell-surface glycoproteins that are present in keratinocytes. These pemphigus vulgaris glycoproteins are members of the desmoglein (DSG) subfamily of the cadherin superfamily of cell–cell adhesion molecules, which are present in desmosomes. Whereas high levels of desmoglein 3 (Dsg3) autoantibodies correlate with the severity of oral disease in patients with pemphigus vulgaris, elevated levels of desmoglein 1 (Dsg1) autoantibodies are associated with severity of ______ disease.

The main therapy for pemphigus vulgaris is systemic corticosteroids with or without the addition of other immunosuppressive agents. If the patient responds well to corticosteroids, the dosage can be gradually reduced, but a low maintenance dosage is usually necessary to prevent or minimize the recurrence of ______.

Oral lesions can range from small vesicles to large bullae. When the bullae rupture, they leave extensive areas of ______. Virtually any region of the oral cavity can be involved, but multiple lesions often develop at sites of irritation or trauma.

The presence of autoantibodies can be demonstrated in the oral mucosa of patients with oral pemphigus with the use of immunofluorescence techniques. For direct immunofluorescence, perilesional unfixed frozen sections are incubated with fluorescein-labeled human anti-IgG. With indirect immunofluorescence, unfixed frozen sections of oral or esophageal mucosa from an animal such as a monkey are first incubated with the patient’s serum to allow for the attachment of any serum antibodies to the mucosal tissue. The tissue is then incubated with fluorescein labeled antihuman IgG serum. Differential Diagnosis. The oral lesions of pemphigus vulgaris may be similar to those seen with ______ multiforme.

The main immunoreactants found in biopsy tests by direct immunofluorescence in mucous membrane pemphigoid are IgG and ______, which are confined to the basement membrane.

In patients who are not responsive to corticosteroids or who gradually adapt to them, “steroid-sparing” therapies are used; these consist of combinations of steroids plus other medications such as ______, cyclophosphamide, cyclosporine, dapsone, gold, methotrexate

Rituximab is an anti-CD20 monoclonal antibody that is aimed at the removal of desmoglein-reactive autoantibodies and that is currently being evaluated as an adjunct to treat ______

Chronic Ulcerative Stomatitis clinically presents with chronic oral ulcerations and has a predilection for women during their ______ decade of life

Painful solitary small blisters and erosions with surrounding erythema are present mainly on the gingiva and the lateral border of the tongue. Because of the magnitude and clinical features of the gingival lesions, a diagnosis of ______ gingivitis is considered

Linear deposits of IgA are observed at the epithelial tissue–connective tissue interface. They differ from the granular pattern that is observed with ______ herpetiformis

Approximately 25% of patients with celiac disease have ______

A gluten-free diet is essential for the treatment of celiac disease and dermatitis herpetiformis. Oral ______ is usually needed for patients with newly detected dermatitis herpetiformis to alleviate symptoms promptly.

Systemic ______ erythematosus (SLE) is a severe disease with a 10:1 predilection for women as compared with men. SLE affects vital organs such as the kidneys and heart as well as the skin and mucosa.

Chronic cutaneous lupus erythematosus usually has no systemic signs or symptoms, with ______ being limited to the skin or the mucosal surfaces. The skin ______ are referred to as discoid lupus erythematosus (DLE). DLE merely describes the chronic scarring, atrophy-producing lesion that may develop into hyperpigmentation or hypopigmentation of the healing area

Subacute cutaneous lupus erythematosus present cutaneous lesions that are similar to DLE but that lack the development of scarring and atrophy. In addition, arthritis and arthralgia, low- grade fever, malaise, and myalgia may present in up to 50% of ______ with subacute cutaneous lupus erythematosus.

Erythema multiforme is an acute bullous and macular inflammatory mucocutaneous disease that affects mainly young ______ between the ages of 20 and 40 years; it is rarely seen in children (≤20%).

The genesis of the mucocutaneous lesions is believed to reside in the development of immune complex ______. This is followed by complement fixation that leads to the leukocytoclastic destruction of vascular walls and small vessel occlusion.

There is no specific treatment for erythema multiforme. For mild symptoms, systemic and local antihistamines together with topical anesthetics and the debridement of lesions with an ______ agent are adequate.

An increase in the incidence of skin and oral manifestations of ______ to drugs has been noted since the advent of sulfonamides, barbiturates, and various antibiotics. The cutaneous and oral lesions are attributed to the drug acting as an allergen that sensitizes the tissues.

Eruptions in the oral cavity that result from sensitivity to drugs that have been taken by mouth or parenterally are called stomatitis ______osa. The local reaction from the use of a ______ in the oral cavity (e.g., stomatitis as a result of topical penicillin use) is referred to as stomatitis venenata or contact stomatitis.

In general, drug eruptions in the oral cavity are ______. Vesicular and bullous lesions.