Podcast
Questions and Answers
What is a common treatment for Raynaud’s phenomenon in systemic sclerosis?
What is a common treatment for Raynaud’s phenomenon in systemic sclerosis?
- Immunosuppressants
- Calcium channel blockers (correct)
- Insulin therapy
- Antibiotics
Which condition is characterized by anti-centromere antibodies?
Which condition is characterized by anti-centromere antibodies?
- CREST syndrome (correct)
- Systemic lupus erythematosus
- Primary biliary cholangitis
- Rheumatoid arthritis
What is a potential complication associated with systemic sclerosis?
What is a potential complication associated with systemic sclerosis?
- Osteoporosis
- Hyperthyroidism
- Pulmonary complications (correct)
- Type 1 diabetes mellitus
Which symptom is NOT associated with CREST syndrome?
Which symptom is NOT associated with CREST syndrome?
How does microstomia affect dental treatment?
How does microstomia affect dental treatment?
What condition features telangiectasia among its clinical signs?
What condition features telangiectasia among its clinical signs?
Which treatment can aid in managing oral hygiene issues caused by microstomia?
Which treatment can aid in managing oral hygiene issues caused by microstomia?
What is often avoided to help manage Raynaud’s phenomenon?
What is often avoided to help manage Raynaud’s phenomenon?
What are the characteristic symptoms of Rheumatic Fever?
What are the characteristic symptoms of Rheumatic Fever?
What is a complication of Rheumatic Fever?
What is a complication of Rheumatic Fever?
What is the name of the antibody associated with Systemic Sclerosis?
What is the name of the antibody associated with Systemic Sclerosis?
What is the characteristic skin feature of Systemic Sclerosis?
What is the characteristic skin feature of Systemic Sclerosis?
What is the characteristic facial feature of Systemic Sclerosis?
What is the characteristic facial feature of Systemic Sclerosis?
What is the characteristic dental feature of Systemic Sclerosis?
What is the characteristic dental feature of Systemic Sclerosis?
What is the sex predilection of Systemic Sclerosis?
What is the sex predilection of Systemic Sclerosis?
What is a characteristic laboratory feature of Systemic Sclerosis?
What is a characteristic laboratory feature of Systemic Sclerosis?
What is the primary cause of Type 1 Diabetes Mellitus?
What is the primary cause of Type 1 Diabetes Mellitus?
Which of the following is NOT a common clinical feature of Type 1 Diabetes Mellitus?
Which of the following is NOT a common clinical feature of Type 1 Diabetes Mellitus?
Which of the following genetic factors is primarily linked to Type 1 Diabetes Mellitus?
Which of the following genetic factors is primarily linked to Type 1 Diabetes Mellitus?
What is the primary cause of Diabetic Nephropathy?
What is the primary cause of Diabetic Nephropathy?
What is the characteristic appearance of oral lesions in lupus erythematosus?
What is the characteristic appearance of oral lesions in lupus erythematosus?
Which of the following is a macrovascular complication associated with Diabetes Mellitus?
Which of the following is a macrovascular complication associated with Diabetes Mellitus?
What is the role of the immune system in the development of Type 1 Diabetes Mellitus?
What is the role of the immune system in the development of Type 1 Diabetes Mellitus?
In discoid lupus erythematosus, what is frequently observed alongside oral lesions?
In discoid lupus erythematosus, what is frequently observed alongside oral lesions?
Which of the following is a microvascular complication associated with Diabetes Mellitus?
Which of the following is a microvascular complication associated with Diabetes Mellitus?
What mechanism contributes to tissue damage in autoimmune conditions like lupus?
What mechanism contributes to tissue damage in autoimmune conditions like lupus?
What type of deposition is associated with lupus in terms of immune response?
What type of deposition is associated with lupus in terms of immune response?
Why is impaired wound healing a common complication of Diabetes Mellitus?
Why is impaired wound healing a common complication of Diabetes Mellitus?
Which of the following is NOT a common complication due to autoimmune responses in lupus?
Which of the following is NOT a common complication due to autoimmune responses in lupus?
Which of the following features is commonly associated with cutaneous lupus erythematosus?
Which of the following features is commonly associated with cutaneous lupus erythematosus?
Genetic factors in lupus propensity often relate to which of the following?
Genetic factors in lupus propensity often relate to which of the following?
Lupus cheilitis primarily affects which part of the body?
Lupus cheilitis primarily affects which part of the body?
What is a common treatment modality for mild cases of lupus erythematosus?
What is a common treatment modality for mild cases of lupus erythematosus?
Which factor is generally NOT considered a common characteristic of rheumatoid arthritis?
Which factor is generally NOT considered a common characteristic of rheumatoid arthritis?
What is a potential prognosis for individuals with Chronic Cutaneous Lupus Erythematosus (CCLE)?
What is a potential prognosis for individuals with Chronic Cutaneous Lupus Erythematosus (CCLE)?
Which autoimmune disorder primarily attacks the joints and may also affect various organs such as skin and lungs?
Which autoimmune disorder primarily attacks the joints and may also affect various organs such as skin and lungs?
Which of the following describes a characteristic of systemic lupus erythematosus (SLE)?
Which of the following describes a characteristic of systemic lupus erythematosus (SLE)?
What is a common symptom associated with rheumatoid arthritis?
What is a common symptom associated with rheumatoid arthritis?
Which of the following conditions can be included in the differential diagnosis for lichenoid lesions?
Which of the following conditions can be included in the differential diagnosis for lichenoid lesions?
What is the primary immune cell involved in the inflammatory response seen in rheumatoid arthritis?
What is the primary immune cell involved in the inflammatory response seen in rheumatoid arthritis?
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Study Notes
Microstomia and Systemic Sclerosis
- Systemic sclerosis is treated with medications like penicillamine and corticosteroids.
- Raynaud's phenomenon associated with systemic sclerosis is managed using calcium channel blockers; patients should avoid cold exposure and smoking.
- Patients often experience microstomia, complicating oral hygiene and dental treatments.
- Prognosis for systemic sclerosis is poor due to potential pulmonary, renal, and cardiac complications.
CREST Syndrome
- Considered a mild variant of limited systemic sclerosis.
- Key features include:
- Calcinosis cutis
- Raynaud's phenomenon
- Esophageal dysfunction
- Sclerodactyly
- Telangiectasia
- Associated with anti-centromere antibodies.
Lupus Erythematosus
- Oral manifestations can appear lichenoid or nonspecific; concurrent skin lesions often seen in discoid lupus erythematosus (DLE).
- Lupus cheilitis may occur.
- Treatment includes avoiding sun exposure and using NSAIDs or antimalarials for mild cases; severe cases may require systemic immunosuppressive therapy.
- Prognosis varies:
- Systemic lupus erythematosus (SLE) has a 20-year survival rate of 75%.
- Chronic cutaneous lupus erythematosus (CCLE) has a better prognosis, with potential for remission but risk of transforming into SLE.
Differential Diagnoses for Lichenoid Lesions
- Include:
- Lichen planus
- Lichenoid drug eruption
- Lichenoid reaction to amalgam
- Chronic ulcerative stomatitis
- Lupus erythematosus
- Graft-versus-host disease
- Lichenoid dysplasia
Rheumatoid Arthritis
- Chronic inflammatory autoimmune disorder affecting ~1% of the U.S. population, primarily joints but can involve skin, heart, blood vessels, and lungs.
- More common in females, with genetic and environmental factors influencing onset.
- Activated CD4+ T helper cells release cytokines, leading to inflammation and destruction of bone and cartilage.
- Symptoms include fatigue, weakness, symmetrical joint involvement, and stiffness, especially in hands, feet, and knees.
Diabetes Mellitus
- Two main types:
- Type 1: Autoimmune destruction of pancreatic β cells; common in childhood/adolescence; associated with islet autoantibodies.
- Type 2: Insulin resistance in adulthood; linked with obesity and no islet autoantibodies.
- Common complications include diabetic nephropathy, retinopathy, neuropathy, impaired wound healing, and increased infection risk.
Rheumatic Heart Disease
- Develops post-streptococcal infection; manifests as fever, carditis, migratory polyarthritis, and erythema marginatum.
- No longer indicates antibiotic prophylaxis for dental treatments to prevent infective endocarditis.
Systemic Sclerosis (Scleroderma)
- Affects females more frequently.
- Characterized by smooth, hard skin texture, mouse-like facies, and dense collagen deposition.
- Associated lab finding: anti-Scl 70 (antitopoisomerase I) antibodies.
- Significant complication includes Raynaud's phenomenon and resorption of the ramus angle.
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