oral manifestation of pernicious anemia?
oral manifestation of addisons disease?
oral manifestation of diabetes?
oral manifestation of sjogren syndrome?
oral manifestation of systemic sclerosis?
oral manifestation of SLE?
oral manifestation of lichen planus?
oral manifestation of epidermolysis bullosa?
oral manifestation of pemphigoid?
oral manifestation of pemphigus?
Pernicious anemia - glossitis
Autoantibodies to intrinsic factor:
vitamin B12 deficiency
what is the effect of Pernicious anemia w/ B12?
what is addisons disease?
Adrenal insufficiency with low steroid output
Antibodies to adrenal gland causing adrenal insufficiency, failure
symptoms of addisons disease
Anorexia, nausea, vomiting, diarrhea
Mucosal and skin pigmentation
picture: oral manifestation of addisons disease?
picture: oral manifestation of type 1 diabetes?
what is sjorgens syndrome?
salivary gland enlargement
Antibodies to nucleolar mitochondria:
salivary and lachrymal glands affected
picture: Sjögren's syndrome
what is systemic sclerosis (scleroderma)?
Inflammatory, vascular and fibrotic changes of skin and internal organs
Anti-collagen, anti-DNA topoisomerase 1, and anti-centromere antibodies
what is systemic lupus erythematosus (SLE)?
immune complex formation
pathogens (skin, kidneys, joints)
malar rash (butterfly rash)
Cutaneous Lupus Erythematosus
Atrophic erythematous lesion
what is lichen planus?
local insult (habits, dental material, bateria) results in t cell activation
cytotoxic (CD8) t cells vs basal cells(collagen) = inflammatory lymphocytic infiltrate, destruction of basal cell layer, hyperkeratosis
epithelial dysregulation and dysplasia = small risk of squamous cell carcinoma
what are the usual oral affected sites of lichen planus?
buccal mucosa and dorsal tongue
usually reticular (lacey) or confluent papules
picture: how does bullous disease work?
what is epidermolysis bullosa?
At least 23 distinct forms of the disease: most have a hereditary basis
Epidermolysis bullosa acquisita is not hereditary, however, and appears to be an autoimmune disorder
Antibodies to type VII procollagen leads to dermal-epidermal separation
Adolescents, young adults
Characterized by spontaneous or trauma-induced blister formation
what is linear IgA disease?
Mimics pemphigoid (below)
Vesicles, bullae, ulcers
Deposits of IgA along the basement membrane, react with BM antigens
two forms of penphigoid?
Mucous membrane (cicatricial) pemphigoid
Oral lesions in most cases
Gingival lesions in 90%
Buccal mucosa, palate affected in 30%
Bullous pemphigoid (skin primarily affected)
Oral lesions in up to 40%
disease caused by pemphigoid?
Subepithelial blisters - oral, ocular, skin
autoantibodies of pemphigoid?
To basement membrane antigens of stratified squamous epithelium (at least 6)
Continuous linear band of immune deposits at the basement membrane in ~90% of affected patients
Primarily IgG and C3
which is more common pemphigoid or pemphigus?
pemphigoid is much more common than pemphigus
oral lesions of pemphigus?
Initial manifestation (usually)
Intraepithelial blisters, fragile
Bullous lesions rarely seen in oral cavity
Rupture early, ulcerate
how does pemphigus effect the skin?
Fragile vesicles and bullae
autoantibodies of pemphigus?
IgG, probably pathogenic
To desmoglein-3 (desmosomes of stratified squamous epithelium), responsible for cell-cell adhesion
disease associated with pemphigus?
Desquamative gingivitis, buccal and palatal lesions
Lesions of conjunctiva, nasal mucosa, larynx, esophagus, vagina
Skin blisters enlarge at edges
May cover significant body area
May be fatal
what is desquamative gingivitis associated with?
therapy for pemphigus?
Systemic (prednisone, cyclophosphamide)