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Eforie, nr. Abstract This article aims to review the etiology, clinical features and diagnosis of desquamative gingivitis in order to outline all the aspects necessary to increase the efficiency of patient management. Because of the polymorphic etiology, dental practitioners may elude the correct diagnose. Consequently, we find it important to underline all the clinical features that desquamative gingivitis may have as well as the associated oral lesions. Also we shortly review the systemic disorders that frequently associate desquamative gingivitis.
It is important to know that the muco-cutaneous disorders frequently involved can have an abrupt onset with lesions sometimes confined to the gingiva. In evolution these diseases can be life threatening and a quick treatment can assure not only a more favorable evolution but also a better life quality. Laboratory analyses are mandatory in order to correctly diagnose the main systemic disorder.
Histology and direct immunofluorescence investigations are the most accurate. Remission of the underlining disease brings improvement or even resolution of the oral lesions.
Keywords: Desquamative gingivitis, systemic disease, oral lesions, differential diagnosis Introduction Desquamative gingivitis is a descriptive clinical term for desquamation, erosions, ulcers, vesicles and bullas that involve both free and attached gingival [ 1 , 2 ]. It is usually associated with autoimmune blistering disease like, pemphigus vulgaris, pemphigoid and bullous form of oral lichen planus, but also other systemic disorders.
We find it appropriate make a short review of these autoimmune disease in order to facilitate recognition and diagnoses. Desquamative gingivitis is considered to be a clinical sign of an associated systemic disease more than a disease itself. History Desquamative gingivitis was first described in by Tomes and Tomes [ 1 ], but it was Prinz in who established it was a descriptive term used to define the presence of erythema, desquamation, erosions, and blistering of the attached and marginal gingiva [ 2 ].
In Glickman and Jerome demonstrated furthermore that this alteration of the gingiva was secondary to other systemic conditions [ 4 ]. Etiopathogenesis The oral mucosa consists of a stratified epithelial layer and connective tissue underneath.
Some areas are keratinized and some are non-keratinized. The gingiva is keratinized in order to resist the trauma caused by masticatory forces. The oral mucosa consists of three layers: stratified squamous cell epithelium, lamina propria, and the basement membrane that separates them. Table 1 Electron microscopy findings, modified after [ 5 ] Layer.
Chronic candidiasis Histoplasmosis. Case Report This was a case report of a year-old female patient who reported to the out-patient Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Chennai with a complaint of burning sensation and tenderness in the gums, which worsened on intake of spicy food since 9 months. The patient also noticed the appearance of blisters on her gums on and off which would heal subsequently without any medical intervention. Her medical history was non-contributory. There were no associated ocular, cutaneous or genital lesions. Intraoral examination revealed an erythematous and inflamed labial gingiva with interspersed areas of normal gingiva in relation to 11, 12, 21, The marginal gingiva was scalloped in outline and had rolled borders with absence of melanin pigmentation [ Figure 1 ].
Desquamative Gingivitis - A Clinicopathological Review
Pemphigus Gingival lichen planus Desquamative gingivitis as a presenting feature is most commonly noticed in oral lichen planus OLP. Lichen planus is a relatively common immunologically mediated mucocutaneous disease of unknown aetiology. It is more common in middle-aged to elderly females. Several forms of OLP are described intraorally; reticular, papular, plaque-like, atrophic, bullous and erosive forms.
Bad breath Sensitive gums Desquamative gingivitis, which is sometimes known as gingivosis, is a form of gum disease where the gum tissue layers begin to separate from each other. The division of these gum layers provides space for bacteria to enter and multiply, which leads to infection. The gum tissue that faces out is affected by the condition much more commonly than the tissue closer to the tongue and palate. As the outer layers of the gum tissue shed, you will most likely experience pain since nerves can be affected. The gum will also generally appear redder than normal and can look very aggravated.