4. Contd.. Mucocutaneous disease Lichen planus Pemphigus
vulgaris Pemphigoid and variants Erythema multiforme Dermatitis
herpetiformis Linear IgA disease Epidermolysis bullosa c/c
ulcerative stomatitis Blood disorders Anemia Leukemia
Myelodysplastic syndrome Neutropenia Other white cell dyscrasias
Gammopathies Haematinic deficiencies
5. Vitamin deficiency disorders Vitamin B complex deficiency
Reddening of oral mucosa, tongue with or without ulceration,
swelling and burning Scurvy (vitamin C deficiency) Petechiae in
oral mucosa and swollen bleeding gums Pernicious anaemia, Iron
deficiency Pellagra Bald tongue (atrophic glossitis )
12. Management Ora lesions resolve with immunosuppressive
therapy. For patients with limited skin/ oral disease,
corticosteroids or systemic antimalarial drugs are
appropriate.
13. . 3. Benign mucus membrane pemphigoid O/M : diffuse an
painful ulceration and scarring Intact blister formatoccasionally
may be intraorally (before rupture and ulceration)
14. . 4 . Pemphigus vulgaris O/M ; diffuse painful oral ulcers
, positive nikolsky sign oral lesions are the first manifestation
of disease and may precede the onset of skin lesions.
15. DD : Erosive lichen planus, benign mucus membrane
pemphigoid Management Oral lesions usually resolve with systemic
immunosuppressive therapy but maybe slower to resolve compared to
extraoral lesions.
16. . 5.Crohn disease O/M : diffuse mucosal swelling,
cobblestone mucosa, localised mucogingivitis, deep linear
ulceration, fibrous tissue tags, polyps or nodules, pyostomatitis
vegetans (snail track ulcers on an erythematous base)
17. Management Oral lesions resolve with systemic treatment of
underlying intestinal disease. however persistent ulcers may
require application of topical corticosteroids and persistent
swelling may respond to intralesional injection of triamcinolone
acetonide
18. . 6.Behcet syndrome O/M ; recurrent painful aphthous like
ulcers, usually numerous and especially involving the soft palate
and oropharynx Oral lesions are most common and may be the first
manifestation of the disease.
19. Change in mucosal pigmentation Addison disease O/M :diffuse
melanin pigmention, candidiasis (in patients with autoimmune
polyendocrinopathy- candidiasis- ectodermal dystrophy
syndrome)
22. Periodontal bleeding and inflammation Diabetes melitus O/M:
gingivitis , periodontitis, candidiasis, generalized atrophy of the
tongue papillae,taste dysfunction, salivary dysfunction, burning
mouth syndrome, delayed wound healing
23. Treatment for periodonditis may improve glycemic control
Furthermore severe periodontal disease may be a strong predictor of
various diabetic complications including nephropathy, stroke,
transient ischemic attack, angina , MI and heart failure
24. . HIV associated periodontal disease O/M: linear gingival
erythema necrotising ulcerative gingivitis necrotising ulcerative
periodontitis
30. Syndromes associated with cleft lip and palate Most common
is Pierre Robin syndrome (micrognathia, cleft palate and
glossptosis, airway distress ) Other syndromes includes Goldenhar
syndrome, median cleft face syndrome, orofacial digital syndrome,
Perts syndrome , Nagar syndrome, Oto palato digital syndrome, Down
syndrome and Marfan syndrome
31. Sjogren syndrome Oral signs and symptoms -dry mouth
-cracker sign -burning -salivary swelling -caries -candidiasis
Ocular signs and symptoms -foreign body sensation -inability to
produce tear -light intolerance Other -fatigue, fever -kidney,
muscle, nerve, liver involvement -connective tissue disease
32. Management : Follow up regularly Salivry substitutes Eye
drops Cariescontrol Soft diet Control of secondary infections
33. Delayed Tooth Eruption Local conditions associated with
DTE