ch3 Autoimmune Diseases that Affect the Oral Cavity
- Springfield Technical Community College
- Dental Hygiene
- Dental Hygiene 201
- ch3 Autoimmune Diseases that Affect the Oral Cavity
Last Modified: 2011-06-28
Related Textbooks:Oral Pathology for the Dental Hygienist (ORAL PATHOLOGY FOR THE DENTAL HYGIENIST ( IBSEN))
Related Textbooks:Pocket Atlas of Oral Diseases (Flexibook)
Lupus erythematosus: white, erosive lesions of the oral mucosa
Pemphigus vulgaris: mucosal ulceration, bullae
Benign mucous membrane pemphigoid: mucosal ulceration, desquamative gingivitis
Behçet syndrome: aphthous ulcers
Pernicious anemia: mucosal atrophy, mucosal ulceration, loss of filiform and fungiform papillae
Lacrimal/salivary gland involvement without other autoimmune = primary. With another autoimmune = secondary
Oral manifestations: dry mouth, mucosa becomes red
Xeropthalmia... burning, itching of eyes.
Laboratory: positive reaction to rheumatoid factor (antibody to IgG).
Diagnosis: when 2 of 3 present (xerostomia, keratoconjunctivitis, rheumatoid arthritis/autoimmune)
Tx=NSAIDs. Corticosteroids/immunosuppressives for extreme
Both cellular and humoral immunity are impaired. Antigen/antibody complexes are deposited in various organs. Autoantibodies for DNA in serum.
Skin lesions, arthritis, problems with CNS, lungs, heart, kidneys.
Oral lesions: erythematous plaques, resemble lichen planus.
Tx depends on disease activity. Treated with NSAIDs, hydroxychlorquinone (an antimalarial), and corticosteroids.
Characterized by breakdown of cellular adhesion between epithelial cells: acontholysis. Patient has antibodies active against cell attachment. Often seen in Ashkenazi jews. First signs are in oral cavity.
Oral lesions: shallow ulcers to fragile vesicles or bullae. Bullae are fragile and rupture.
Diagnosis: made by biopsy, microscopic exam, direct/indirect immunofluorescence. Direct immunofluorescence shows fluorescence surround cells of prickle layer. Indirect immunofluorescence shows presence of circulating autoantibodies.
Tx= High doses of corticosteroids/other immunosuppressive drugs like methotrexate.
Benign Mucous Membrane Pemphigoid (BMMP) (1 of 2)
Benign Mucous Membrane Pemphigoid (BMMP) (2 of 2)
Direct immunofluorescence shows linear fluorescence at basement membrane.
Tx= Mild cases: Topical corticosteroid. Severe cases: Systemic corticosteroids.
Circulating autoantibodies are usually detectable, but do not relate to disease activity.
Oral lesions are less common.
Microscopic appearance shows epithelium separating from connective tissue at the basement membrane.
Tx= high doses of corticosteroids/NSAIDs.
Onset is at 30 years of age. Incereased in those of
Mediterranean, Assian descent.
Markers HLA B5 and HLA B51.
Oral ulcers are similar to aphthous ulcers, genital lesions are small, ocular lesions begin with photophobia.
Diagnosis requires 2 of the 3 manifestations (oral/genital/ocular). Pustular lesion develops after needle puncture.
Tx=topical corticosteriods/other immunosuppressives.
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