Desquamative gingivitis
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| synonyms = DG
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Desquamative gingivitis is an erythematous (red), desquamatous (shedding) and ulcerated appearance of the gums.{{Cite book |title=Carranza's clinical periodontology |publisher=Elsevier/Saunders |year=2012 |isbn=978-1-4377-0416-7 |editor-last=Newman |editor-first=Michael G. |edition=11th |location=St. Louis, Mo |pages=111–126 |editor-last2=Takei |editor-first2=Henry H. |editor-last3=Carranza |editor-first3=Fermín A.}} It is a descriptive term and can be caused by several different disorders.{{cite journal|last=Lo Russo|first=L|author2=Fedele, S |author3=Guiglia, R |author4=Ciavarella, D |author5=Lo Muzio, L |author6=Gallo, P |author7=Di Liberto, C |author8=Campisi, G |title=Diagnostic pathways and clinical significance of desquamative gingivitis.|journal=Journal of Periodontology|date=January 2008|volume=79|issue=1|pages=4–24|doi=10.1902/jop.2008.070231|pmid=18166088}}
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.{{Cite book |url=https://www.worldcat.org/title/427608817 |title=Clinical problem solving in dentistry |publisher=Churchill Livingstone |year=2010 |isbn=978-0-443-06784-6 |editor-last=Odell |editor-first=E. W. |edition=3rd |series=Clinical problem solving in dentistry series |location=Edinburgh ; New York |page=192 |oclc=427608817}} The term "full width gingivitis" usually refers to the oral lesions of orofacial granulomatosis however.{{Cite book |last=Welbury R |url=https://books.google.com/books?id=vvh7nqNxvyYC&q=%22full+width+gingivitis%22&pg=PT26 |title=Paediatric dentistry |last2=Duggal M |last3=Hosey MT |publisher=Oxford University Press |year=2012 |isbn=978-0-19-957491-9 |editor-last=Welbury |editor-first=Richard |edition=4th |location=Oxford |page=319 |editor-last2=Duggal |editor-first2=Monty S. |editor-last3=Hosey |editor-first3=Marie Thérèse}} The color is another dissimilarity between typical marginal gingivitis and desquamative gingivitis, in the latter it is dusky red. Plasma cell gingivitis is another form of gingivitis which affects both the attached and free gingiva.
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. 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. The exact cause of desquamative gingivitis cannot be determined about a third of cases.
- Oral lichen planus
- Cicatricial pemphigoid or less commonly bullous pemphigoid
- Pemphigus vulgaris
- Linear immunoglobulin A disease
- Dermatitis herpetiformis
- Lupus erythematosus
- Chronic ulcerative stomatitis
- Chronic bacterial, fungal, and viral infections
- Reactions to medications, mouthwashes, and chewing gum
Rare causes include:
- Crohn's disease
- Sarcoidosis
- Leukemia
- factitious (self inflicted) lesions
- Squamous cell carcinoma (can be mistaken for desquamative gingivitis)
Treatment
- Improving oral hygiene
- Minimising irritation of the lesions
- Specific therapies for the underlying disease (where available)
- Local or systemic immunosuppressive or dapsone therapy (notably not corticosteroids)
History
References
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External links
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| ICD10 = K05.1 (ILDS K05.130)
| ICD9 = {{ICD9|523.10}}
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{{Oral pathology}}
{{periodontology}}