Desquamative gingivitis

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Desquamative gingivitis
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Desquamative gingivitis is an erythematous (red), desquamatous (shedding) and ulcerated appearance of the gums. [1] It is a descriptive term and can be caused by several different disorders. [2]

Contents

Signs and symptoms

Desquamative gingivitis involves lesions of the free and attached gingiva. Unlike plaque-induced inflammation of the gums (normal marginal gingivitis), desquamative gingivitis extends beyond the marginal gingiva, involving the full width of the gingiva and sometimes the alveolar mucosa. [3] The term "full width gingivitis" usually refers to the oral lesions of orofacial granulomatosis however. [4] The color is another dissimilarity between typical marginal gingivitis and desquamative gingivitis, in the latter it is dusky red. [3] Plasma cell gingivitis is another form of gingivitis which affects both the attached and free gingiva. [1]

Cause

Caused by various autoimmune diseases as well as allergies. Erosive lichen planus, mucous membrane pemphigoid, pemphigus vulgaris, erythema exsudativum multiforme and lupus erythematosus.

Diagnosis

Differential diagnosis

Desquamative gingivitis is a descriptive clinical term, not a diagnosis. [1] Dermatologic conditions cause about 75% of cases of desquamative gingivitis, and over 95% of the dermatologic cases are accounted for by either oral lichen planus or cicatricial pemphigoid. [1] The exact cause of desquamative gingivitis cannot be determined about a third of cases. [1]

Rare causes include:

Treatment

History

This condition was first recognized and reported in 1894, but the term desquamative gingivitis was not coined until 1932. [1]

Related Research Articles

<span class="mw-page-title-main">Necrotizing gingivitis</span> Non-contagious, painful bacterial infection of the gums

Necrotizing gingivitis (NG) is a common, non-contagious infection of the gums with sudden onset. The main features are painful, bleeding gums, and ulceration of inter-dental papillae. This disease, along with necrotizing periodontitis (NP) and necrotizing stomatitis, is classified as a necrotizing periodontal disease, one of the three general types of gum disease caused by inflammation of the gums (periodontitis).

<span class="mw-page-title-main">Lichen planus</span> Human chronic inflammatory disease

Lichen planus (LP) is a chronic inflammatory and autoimmune disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, but is named for its appearance. It is characterized by polygonal, flat-topped, violaceous papules and plaques with overlying, reticulated, fine white scale, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. The hue may be gray-brown in people with darker skin. Although there is a broad clinical range of LP manifestations, the skin and oral cavity remain as the major sites of involvement. The cause is unknown, but it is thought to be the result of an autoimmune process with an unknown initial trigger. There is no cure, but many different medications and procedures have been used in efforts to control the symptoms.

<span class="mw-page-title-main">Pemphigus</span> Blistering autoimmune diseases

Pemphigus is a rare group of blistering autoimmune diseases that affect the skin and mucous membranes. The name is derived from the Greek root pemphix, meaning "blister".

<span class="mw-page-title-main">Stomatitis</span> Medical condition

Stomatitis is inflammation of the mouth and lips. It refers to any inflammatory process affecting the mucous membranes of the mouth and lips, with or without oral ulceration.

The oral mucosa is the mucous membrane lining the inside of the mouth. It comprises stratified squamous epithelium, termed "oral epithelium", and an underlying connective tissue termed lamina propria. The oral cavity has sometimes been described as a mirror that reflects the health of the individual. Changes indicative of disease are seen as alterations in the oral mucosa lining the mouth, which can reveal systemic conditions, such as diabetes or vitamin deficiency, or the local effects of chronic tobacco or alcohol use. The oral mucosa tends to heal faster and with less scar formation compared to the skin. The underlying mechanism remains unknown, but research suggests that extracellular vesicles might be involved.

<span class="mw-page-title-main">Pemphigoid</span> Autoimmune blistering diseases

Pemphigoid is a group of rare autoimmune blistering diseases of the skin, and mucous membranes. As its name indicates, pemphigoid is similar in general appearance to pemphigus, but, unlike pemphigus, pemphigoid does not feature acantholysis, a loss of connections between skin cells.

<span class="mw-page-title-main">Cheilitis</span> Inflammation of the lips

Cheilitis is a medical condition characterized by inflammation of the lips. The inflammation may include the perioral skin, the vermilion border, or the labial mucosa. The skin and the vermilion border are more commonly involved, as the mucosa is less affected by inflammatory and allergic reactions.

Bleeding on probing (BoP) which is also known as bleeding gums or gingival bleeding is a term used by dentists and dental hygienists when referring to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus, or interface between the gingiva and a tooth. BoP is a sign of periodontal inflammation and indicates some sort of destruction and erosion to the lining of the sulcus or the ulceration of sulcular epithelium. The blood comes from lamina propria after the ulceration of the lining. BoP seems to be correlated with Periodontal Inflamed Surface Area (PISA).

<span class="mw-page-title-main">Gingival enlargement</span> Human disease

Gingival enlargement is an increase in the size of the gingiva (gums). It is a common feature of gingival disease. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. The treatment is based on the cause. A closely related term is epulis, denoting a localized tumor on the gingiva.

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

Paraneoplastic pemphigus (PNP) is an autoimmune disorder stemming from an underlying tumor. It is hypothesized that antigens associated with the tumor trigger an immune response resulting in blistering of the skin and mucous membranes.

<span class="mw-page-title-main">Plasma cell gingivitis</span> Medical condition

Plasma cell gingivitis is a rare condition, appearing as generalized erythema (redness) and edema (swelling) of the attached gingiva, occasionally accompanied by cheilitis or glossitis. It is called plasma cell gingivitis where the gingiva (gums) are involved, plasma cell cheilitis, where the lips are involved, and other terms such as plasma cell orifacial mucositis, or plasma cell gingivostomatitis where several sites in the mouth are involved. On the lips, the condition appears as sharply outlined, infiltrated, dark red plaque with a lacquer-like glazing of the surface of the involved oral area.

Epulis is any tumor like enlargement situated on the gingival or alveolar mucosa. The word literally means "(growth) on the gingiva", and describes only the location of the mass and has no further implications on the nature of the lesion. There are three types: fibromatous, ossifying and acanthomatous. The related term parulis refers to a mass of inflamed granulation tissue at the opening of a draining sinus on the alveolus over the root of an infected tooth. Another closely related term is gingival enlargement, which tends to be used where the enlargement is more generalized over the whole gingiva rather than a localized mass.

<span class="mw-page-title-main">Angina bullosa haemorrhagica</span> Medical condition

Angina bullosa haemorrhagica is a condition of the mucous membranes characterized by the sudden appearance of one or more blood blisters within the oral cavity. The lesions, which may be caused by mild trauma to the mouth tissues such as hot foods, typically rupture quickly and heal without scarring or further discomfort. The condition is not serious except in rare cases where a large bulla that does not rupture spontaneously may cause airway obstruction.

<span class="mw-page-title-main">Necrotizing periodontal diseases</span> Bacterial infection of the oral mucosa and periodontium

Necrotizing periodontal diseases is one of the three categories of periodontitis as defined by the American Academy of Periodontology/European Federation of Periodontology 2017 World Workshop classification system.

Mucous membrane pemphigoid is a rare chronic autoimmune subepithelial blistering disease characterized by erosive lesions of the mucous membranes and skin. It is one of the pemphigoid diseases that can result in scarring.

A vulvar disease is a particular abnormal, pathological condition that affects part or all of the vulva. Several pathologies are defined. Some can be prevented by vulvovaginal health maintenance.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 (editors) Newman MG, Takei HH, Klokkevold PR, Carranza FA (2012). Carranza's clinical periodontology (11th ed.). St. Louis, Mo.: Elsevier/Saunders. pp. 111–126. ISBN   978-1-4377-0416-7.{{cite book}}: |last= has generic name (help)CS1 maint: multiple names: authors list (link)
  2. Lo Russo, L; Fedele, S; Guiglia, R; Ciavarella, D; Lo Muzio, L; Gallo, P; Di Liberto, C; Campisi, G (January 2008). "Diagnostic pathways and clinical significance of desquamative gingivitis". Journal of Periodontology. 79 (1): 4–24. doi:10.1902/jop.2008.070231. PMID   18166088.
  3. 1 2 Odell EW (Editor) (2010). Clinical problem solving in dentistry (3rd ed.). Edinburgh: Churchill Livingstone. p. 192. ISBN   9780443067846.{{cite book}}: |last= has generic name (help)
  4. Welbury R; Duggal M; Hosey MT (2012). Paediatric dentistry (4th ed.). Oxford: Oxford University Press. p. 319. ISBN   978-0199574919.