ORAL PATHOLOGY: VESICULAR LESIONS [1]

PRIMARY HERPETIC GINGIVOSTOMATITIS

CLINICAL FEATURES:

• rarely occurs before 6 months 

• short, yellowish, fluid-filled vesicles develop

HISTOLOGIC FEATURES: 

• intraepithelial blisters filled with fluid 

• lipschutz bodies 

• degenerating cells show ballooning degeneration 

MODE OF TRANSMISSION: 

• direct contact 

• droplet infection 

TREATMENT:

• unsatisfactory because disease is unalterable 

• antibiotic 

ERYHTEMA MULTIFORME

ERYTHEMA MULTIFORME EXUDATIVUM

STEVENS-JOHNSON SYNDROME

CLINICAL FEATURES:

• young adults, males 

• recurrence of disease over period of years is common 

DIFFERENTIAL DIAGNOSIS:

• chicken pox

• herpes zoster 

TREATMENT AND PROGNOSIS 

• no specific

• ACTH

• seldom px’s life is endangered but chronic episode is disconcerting

STEVENS-JOHNSON SYNDROME

ORAL MUCOUS MEMBRANE

STOMATITIS VENENATA

DERMATITIS VENENATA

CONTACT DERMATITIS

CLINICAL FEATURES:

• itching/burning sensation at site of contact → erythema → vesicle

• if chronic: skin becomes thick and dry

ETIOLOGY:

• dental or cosmetic preparations

• dental materials

• dental therapeutic agents

ORAL MANIFESTATIONS:

• secondary infection is common

• small vesicles form but transient and soon rupture to form erosions

TREATMENT:

• discontinue contact with the offending material

STOMATITIS MEDICAMENTOSA

DRUG ALLERGY

DRUG IDIOSYNCRASY

DERMATITIS MEDICAMENTOSA

CLINICAL FEATURES:

• skin lesions

• fever

• lymphadenopathy

ORAL MANIFESTATIONS:

• common in gingiva, lips, palate, tongue

• gingival lesion similar to ANUG

TREATMENT AND PROGNOSIS:

• antihistamine

• abstinence of particular drug involved

PEMPHIGUS

CLINICAL FEATURES:

• equal distribution of occurrence in males and females

• common among Jewish persons

HISTOLOGICAL FEATURES:

• loss of cohesiveness between epithelial cells, because of this, clamps of epithelial cells called Tzanck cells are found

ETIOLOGY:

• unknown

ORAL MANIFESTATIONS:

• severe pain

• profuse salivation

DIFFERENTIAL DIAGNOSIS:

1. erythema multiform 

2. bullous lichen planus

TREATMENT:

• steroid and antibiotic (for secondary infection)

• corticosteroids

PEMPHIGUS VEGETANS

PEMPHIGUS FOLLACEUS

PEMPHIGUS ERYTHEMATOSUS OR SENEAR-USHER SYNDROME

PEMPHIGUS VULGARIS