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Desquamative gingivitis associated with oral lichen planus. Reticular lesions of buccal mucosa in addition to gingiva.
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... is a relatively common, T-cell-mediated chronic inflammatory disease of unknown etiology. LP commonly occurs in middle-aged and older people, and women are affected more frequently than men [53,54]. The lesions are found in multiple regions including the skin, genitalia, or oral mucosa, although they are confined to the gingiva alone in some cases [53][54][55][56] (Figures 2 and 3). In many instances, atrophic, ulcerative, and bullous forms are combined as erosive LP. The reticular, popular, and plaque-like forms of LP are often asymptomatic, whereas erosive forms may be quite painful when a patient is eating spicy foods or performing oral hygiene procedures [53][54][55]57] (Figures 4-6). For these reasons, erosive LP usually requires treat- ment. Histopathologically, specimens may demonstrate hyperortho-or hyperparakeratosis, degenerative changes to the basal cells, and band-like subepithelial infiltrate composed of lymphocytes [11] (Figure 7). When available, DIF testing is also valuable in establishing the diagnosis, although DIF findings are only suggestive, rather than diagnostic, of LP [6,10,48,58]. Characteristic DIF findings in oral LP include a linear pattern of anti-fibrin or anti-fibrino- gen in the basement membrane zone and, to a lesser degree, the presence of IgM or IgG depos- its in cytoid bodies [6,10,48,58] (Figure ...
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Background and Objectives: Desquamative gingivitis (DG) is a clinical term indicating “peeling gums” and is associated with different oral manifestations. In this study, we aimed to assess the association between DG and autoimmune blistering mucocutaneous diseases (ABMD) with oral manifestations. Materials and Methods: A retrospective study including 88 patients diagnosed between 1998 and 2019 with ABMD (intraepithelial and subepithelial autoimmune blistering diseases) was performed at the Oral Medicine Department, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy in Bucharest. For each patient, the sociodemographic and anamnestic data, as well as clinical features of oral lesions (location), histological evaluation, and direct immunofluorescence data were collected. Results: Most of the patients involved in the study were female (78.4%). In total, 34 patients (38.63%) were diagnosed with subepithelial autoimmune diseases (SAD) and 54 (61.36%) had intraepithelial autoimmune diseases (IAD). Differences in the anatomic distribution of oral involvement were found between SAD and IAD. The presence of DG was significantly more common in patients with SAD compared to those with a diagnosis of IAD. Conclusions: Specific anatomical locations of the oral lesions are significantly associated with different subtypes of ABMD, with gingiva and hard palate mucosa being more involved in SAD and the soft palate and buccal mucosa in IAD. Desquamative gingivitis is a clinical sign that raises diagnostic challenges for several conditions in oral medicine.
