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Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment

Desquamative gingivitis (DG) is a clinical term that describes erythema, desquamation and erosions of the gingiva, of various etiologies. Although the clinical aspect is not specific for a certain disease, an accurate diagnosis of the underlying disorder is necessary because the disease course, prog...

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Autores principales: Sciuca, Ana Maria, Toader, Mihaela Paula, Stelea, Carmen Gabriela, Maftei, George Alexandru, Ciurcanu, Oana Elena, Stefanescu, Ovidiu Mihail, Onofrei, Bianca-Andreea, Popa, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322493/
https://www.ncbi.nlm.nih.gov/pubmed/35885656
http://dx.doi.org/10.3390/diagnostics12071754
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author Sciuca, Ana Maria
Toader, Mihaela Paula
Stelea, Carmen Gabriela
Maftei, George Alexandru
Ciurcanu, Oana Elena
Stefanescu, Ovidiu Mihail
Onofrei, Bianca-Andreea
Popa, Cristina
author_facet Sciuca, Ana Maria
Toader, Mihaela Paula
Stelea, Carmen Gabriela
Maftei, George Alexandru
Ciurcanu, Oana Elena
Stefanescu, Ovidiu Mihail
Onofrei, Bianca-Andreea
Popa, Cristina
author_sort Sciuca, Ana Maria
collection PubMed
description Desquamative gingivitis (DG) is a clinical term that describes erythema, desquamation and erosions of the gingiva, of various etiologies. Although the clinical aspect is not specific for a certain disease, an accurate diagnosis of the underlying disorder is necessary because the disease course, prognosis and treatment vary according to the cause. DG may inflict significant oral discomfort, which is why patients typically present to the dentist for a first consultation, rendering it important for these specialists to be informed about this condition. Our paper aims to review the ethiopatogenesis and diagnostic approach of DG, focusing on the most common underlying disorders (autoimmune bullous dermatoses and lichen planus) and on the management of these patients. Potential etiological agents leading to an inflammatory immune response in the oral mucosa and DG appearance include genetic predisposition, metabolic, neuropsychiatric, infectious factors, medication, dental materials, graft-versus-host reaction and autoimmunity. A thorough anamnesis, a careful clinical examination, paraclinical explorations including histopathological exam and direct immunofluorescence are necessary to formulate an appropriate diagnosis. Proper and prompt management of these patients lead to a better prognosis and improved quality of life, and must include management in the dental office with sanitizing the oral cavity, instructing the patient for rigorous oral hygiene, periodic follow-up for bacterial plaque detection and removal, as well as topical and systemic therapy depending on the underlying disorder, based on treatment algorithms. A multidisciplinary approach for the diagnosis and follow-up of DG in the context of pemphigus vulgaris, bullous pemphigoid, cicatricial pemhigoid or lichen planus is necessary, including consultations with dermatologists, oral medicine specialists and dentists.
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spelling pubmed-93224932022-07-27 Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment Sciuca, Ana Maria Toader, Mihaela Paula Stelea, Carmen Gabriela Maftei, George Alexandru Ciurcanu, Oana Elena Stefanescu, Ovidiu Mihail Onofrei, Bianca-Andreea Popa, Cristina Diagnostics (Basel) Review Desquamative gingivitis (DG) is a clinical term that describes erythema, desquamation and erosions of the gingiva, of various etiologies. Although the clinical aspect is not specific for a certain disease, an accurate diagnosis of the underlying disorder is necessary because the disease course, prognosis and treatment vary according to the cause. DG may inflict significant oral discomfort, which is why patients typically present to the dentist for a first consultation, rendering it important for these specialists to be informed about this condition. Our paper aims to review the ethiopatogenesis and diagnostic approach of DG, focusing on the most common underlying disorders (autoimmune bullous dermatoses and lichen planus) and on the management of these patients. Potential etiological agents leading to an inflammatory immune response in the oral mucosa and DG appearance include genetic predisposition, metabolic, neuropsychiatric, infectious factors, medication, dental materials, graft-versus-host reaction and autoimmunity. A thorough anamnesis, a careful clinical examination, paraclinical explorations including histopathological exam and direct immunofluorescence are necessary to formulate an appropriate diagnosis. Proper and prompt management of these patients lead to a better prognosis and improved quality of life, and must include management in the dental office with sanitizing the oral cavity, instructing the patient for rigorous oral hygiene, periodic follow-up for bacterial plaque detection and removal, as well as topical and systemic therapy depending on the underlying disorder, based on treatment algorithms. A multidisciplinary approach for the diagnosis and follow-up of DG in the context of pemphigus vulgaris, bullous pemphigoid, cicatricial pemhigoid or lichen planus is necessary, including consultations with dermatologists, oral medicine specialists and dentists. MDPI 2022-07-20 /pmc/articles/PMC9322493/ /pubmed/35885656 http://dx.doi.org/10.3390/diagnostics12071754 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Sciuca, Ana Maria
Toader, Mihaela Paula
Stelea, Carmen Gabriela
Maftei, George Alexandru
Ciurcanu, Oana Elena
Stefanescu, Ovidiu Mihail
Onofrei, Bianca-Andreea
Popa, Cristina
Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment
title Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment
title_full Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment
title_fullStr Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment
title_full_unstemmed Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment
title_short Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment
title_sort desquamative gingivitis in the context of autoimmune bullous dermatoses and lichen planus—challenges in the diagnosis and treatment
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322493/
https://www.ncbi.nlm.nih.gov/pubmed/35885656
http://dx.doi.org/10.3390/diagnostics12071754
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