Oral path chapter 3.2

Autoimmune diseases

-immunologic tolerance

-autoimmune disorder

The body learns to distinguish self from nonself

Immunologic tolerance

When the recognition mechanism breaks down

Autoimmune disorder

With an autoimmune disorder some body cells are

Not tolerated and treated as a foreign antigen

A deficiency in number function or interrelationship of the involved WBCs and their products

Immunopathologic condition

An immunopathologic condition is

Congenital or acquired

With an immunodeficiency what occurs as s result of the deficiency

Infections and tumors

Painful oral ulcers with an unclear cause

aphthous ulcers

Three types of aphthous ulcers

-minor

-major

-herpetiform

Most common precipitating factor for aphthous ulcer

Trauma

Other precipitating factors for aphthous ulcers

-emotional stress

-certain foods

What disease is associated with aphthous ulcer

Certain systemic disease

Another name for aphthous ulcers

-canker sore

-aphthous stomatitis

recurrent aphthous ulcers are usually due to

-trauma

-food associations

-menstruation

-systemic disease

-tobacco cessation

-stress

Minor aphthous ulcers

-discrete

-round or oval

Minor ulcers occur on the

Movable mucosa

Size in diameter of a minor ulcer

1cm

Characteristics of minor aphthous ulcers

-erthematous halo

-surrounding yellow white fibrin surface

-single or multiple lesions

-prodrome of 1-2 days

Major aphthous ulcers are also known as

Sutton disease

-periadenitis mucosa necrotica recurrens

Size of major AU

Larger than 1cm

Major AU compared to minor AU

Major is deeper and longer lasting

-very painful

Where does major AU occur

Posterior of the mouth

How long does it take major AU to heal

Several weeks

Major AU may require

Biopsy

Herpetiform aphthous ulcers resemble

Herpes simplex

Characteristic os herpetiform AU

-tiny 1-2mm

-painful

-occur in groups

Multiple areas of well demarcated swelling of skin

Urticaria

Urticaria is also known as

Hives

Urticaria often includes

(Pruritus) itching

Urticaria lesions are caused by

localized areas of vascular permeability in superficial connective tissue

Angioedema

Localized areas of swelling beneath the skin, often around the eyes and lips, but it can also involve other body areas as well. (Deeper blood vessels)

Angioedema are lesions caused by

Diffuse swelling because of increased permeability of deeper blood vessels

How does the skin of Angioedema appear

Normal and usually does not itch

Causes of urticaria and Angioedema

Idiopathic

Infection

Trauma

Emotional stress

Systemic diseases

Ingested allergens

Treatement for urticaria and Angioedema

-antihistaminic drugs

-epinephrine

Lesion that results from contact of an allergen with skin or mucosa

Allergic contact Mucositis and dermatitis

Allergic contact Mucositis and dermatitis invloves

T cells in a cell mediated immune response

What type of hypersensitivity is allergic contact Mucositis and dermatitis

Type IV hypersensitivity

The cause of allergic contact Mucositis is not always

Known

Possible causes of contact Mucositis and contact dermatitis

-Preservatives in local anesthetics

-Topical medications

-Acrylics

-Metal-based alloys

-Epoxy resins

-Flavoring agents

-Gloves

Treatement of contact mucosistis and contact dermatitis

-topical corticosteroid

-systemic corticosteroids

Lesions that appear in the same site each time a drug is introduced

Fixed drug eruptions

When doe fixed drug eruptions generally appear and subside

-appear suddenly after latent period

-subside when drug is stoped

Fixed Drug Eruption characteristics

-single or multiple

-slightly raised

-reddish patches

-clusters of macules on the mucous

Fixed drug eruptions include

-pain

-pruritus

What type of allergic reaction is fixed drug eruptions

Type 3

Acute self limited disease that affects skin and mucous membranes

erythema multiforme

Cause of erythema multiforme

Not clear; may be a hypersensitivity reaction

Erythema multiforme characteristics

Target or bulls eye lesions

Used to be considered a very severe form of erythema multiforme=rme

Steven's-Johnson syndrome

Steven Johnson syndrome is now classified as

A variant of toxic epidermal necrolysis

Benign chronic disease affecting the skin and oral mucosa

Lichen planus

Cause of lichen plants

Unknown cause

Lichen plants has characteristics like

Wickham striae (lace like)

Lichen planus is most commonly found on

The buccaneers mucosa

Lichen planus is also found on the

-tongue

-lips

-floor of mouth

-gingiva

What % of the US has lichen planus

2%

Lichen planus is more commonly found in

-middle age

-women

Types of lichen planus

-Reticular lichen planus; most common form

-Erosive and bullous lichen planus; epithelium separates from connective tissue

What can be associated with lichen planus

desquamative gingivitis

Skin lesions of lichen planus

papules (2-4mm) most commonly in lumbar region, flexor surfaces of the wrist, anterior ankle

Classic syndrome of reactive arthritis includes

-arthritis

-urethritis

-conjuctivitis

Antigenic marker that means there may be a genetic influence of reactive arthritis

HLA-B27

Reactive arthritis is probably a abnormal immune response to

Microbial antigen