Term
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Definition
| Circumoral inflammatory skin disease with or without bacterial infection |
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Term
| Etiology of perioral dermatitis |
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Definition
Idiosyncratic response to exogenous materials: tartar control toothpaste, bubble gum, moisturizers, night creams, makeup, etc
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Term
| True or false: you treat perioral dermatitis w/ corticosteroids. |
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Definition
| False, corticosteroids make it worse |
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Term
| Clinical features of perioral dermatitis |
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Definition
Persistent erythematous papules/pustules
Vermillion spared, usually zone of uninovlved skin; +/- pruritis
90% women, in children no gender predilection
Tartar control toothpaste cases causing only erythema (no pustules and erythema spreads to vermillion - no spared skin) circumoral dermatitis (not classic perioral dermatitis)
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Term
| Histology of perioral dermatitis |
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Definition
Variable
Chronic lymphohistiocyte dermatitis w/ spongiosis of hair follicles
Roseaca like pattern - perifollicular granulomatous inflammation (mimics sarcoid) |
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Term
| Histology of cinnamon-induced stomatitis |
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Definition
Lichenoid mucositis
Perivascular lymphocytic infiltrates |
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Term
| Etiology of transient lingual papillitis |
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Definition
Common
Unknown cause Suspects include local irritation, stress, GI disease, URTI, hormone fluctuation, viral infection, topical hypersensitivity to food, drinks or OH products |
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Term
| 3 patterns of clinical features of transient lingual papillitis |
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Definition
1. Localized 1 or more enlarge fungiform papillae - red, may have fibrinous cap, mild-mod pain, resolve w/in hrs to several days; anterior dorsal tongue F>M
2. Generalized, affecting many of fungiform papillae on tip and lateral tongue; papillae can be red, eroded & painful; + fever, lymphadenopathy; familial cases reported resovles w/in 7 days
3. Diffuse, elevated white papules; asymptomatic, papulokeratotic varient; allergy or frictional hyperkeratosis suspected
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Term
| Histologic features of types 1 & 2 transient lingual papillitis |
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Definition
| Normal epi w/ ulceration or exocytosis of neutrophils; mixed inflam infiltrate in CT. Neg for HSV, HPV, fungi |
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Term
| Histologic features of type 3 transient lingual papillitis |
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Definition
| Marker shaggy hyperparakeratosis w/ bacterial colonization; chronic lymphocytic infiltrate in CT w/ extension into lower portion of epi |
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Term
| Treatment for transient lingual papillitis |
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Definition
Resolves spontaneously; topical corticosteroids; anesthetics, coating agents used to reduce pain or duration
Some pts report removing them
No treatment needed for type 3 which is asymptomatic |
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Term
| Prognosis for transient lingual papillitis |
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Definition
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Term
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Definition
1. Mast cell degranulation (Histamine, IgE mediated hypersensitivity - medications, foods, stress, exercise, cold)
2. Angiotensin converting enzyme (ACE) inhibitors (mediated by bradykinins; can occur with initial use or dental procedures in long term users)
3. Hereditary (auto-dom - lack of C1 esterase inhibitor or inhibitor present but not functional --> rare)
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Term
| Clinical features of angioedema |
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Definition
Rapid swelling of soft tissues
Eyes, lips, hands
Itching, erythema
Resp and GI problems most common w/ hereditary types
Resp difficulties w/ ACE related angioedema |
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Term
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Definition
Depends on type and response to treatment
May be fatal w/ dental treatment
Prevention if possible |
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Term
| Immunopathogenesis of Aphthous ulcers |
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Definition
Cell-mediated immune response
Mononuclear infiltrate of T lymphocytes (macrophages & mast cells) w/ production of TNFalpha which induces inflammation
TNFalpha synthesis can be suppressed w/ thalidomide & pentoxyifylline, or cytokines interleukins IL-2 or IL-10 & natural killer cells activated by IL-2
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Term
| Host Factors - susceptibility of aphthous ulcers |
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Definition
Genetic (HLA studes)
Nutritional (iron, folate, B12)
Systemic disease
Salivary gland dysfunction
Endocrine (85% improve during preg)
Immunity, abnormal immune response |
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Term
| Summary of factors for aphthous ulcers |
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Definition
Decrease of mucosal barrier - mucosal atrophy (anemia) or decrease in mucosal barrier (saliva)
Increase in antigenic exposure/hypersensitivites
Primary immune dysregulation (cyclic neutropenia AIDS)
One or more may be a factor in each patient
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Term
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Definition
| Burning sensation, swelling, erythema, ulcer usually dev w/in 24 hrs, no blisters |
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Term
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Definition
Less than 1 cm in diameter w/ a regular, erythematous outline w/ a gray or yellow base
Usually on freely movable, lining mucosa
Occurs singly or in crops <10 lesions
Ulcers heal in 3-14 days w/out scar formation |
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Term
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Definition
More sever >1cm diameter, w/ an irregular outline
Single or multiple
May take weeks-months to heal
May heal w/ scar formation |
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