DESQUAMATIVE GINGIVITIS Does it always require a biopsy

“ DESQUAMATIVE GINGIVITIS ” - Does it always require a biopsy? ? ?

INTRODUCTION Is a clinical term to describe red, painful, glazed and friable gingiva which may be a manifestation of varied disease 12/21/2021 MOKSHA'17 2

CASE RECORD • 55 year old/Female • Chief Complaint: Burning sensation and pain all over the gums for 1 month • Medical Hx: Known Diabetic and Hypertensive for 3 years 12/21/2021 MOKSHA'17 3

EXTRA-ORAL EXAMINATION Reticulated brown hyper pigmentation of the skin on the hands. 12/21/2021 MOKSHA'17 4

INTRA ORAL EXAMINATION INSPECTION • Diffuse erythematous and inflamed marginal gingiva. • Loss of stippling. PALPATION • Probing leaving a raw eroded surface 12/21/2021 MOKSHA'17 5

PROVISIONAL DIAGNOSIS Desquamative gingivitis DIFFERENTIAL DIAGNOSIS • Erosive lichen planus • Mucous membrane pemphigoid • Allergic gingivitis 12/21/2021 MOKSHA'17 6

T R E A T M E N T 12/21/2021 MOKSHA'17 Clobetasol propionate (0. 05%) Antacids Multivitamin 7

Follow up – 1 st visit 12/21/2021 MOKSHA'17 8

Follow up – 2 nd visit 12/21/2021 MOKSHA'17 9

REVIEW § Women § 4 th – 5 th decade § Difficult to eat hot, spicy food. § Multiple vesicle and superficial denuded areas. § Nickolsky`s sign may be positive. § Etiology is unclear. 12/21/2021 MOKSHA'17 10

Clinical features § Erythema and edema of marginal and attached gingiva. § Desquamation of epithelium, painful erosive lesions, haemorrhagic bullae. § Misleading diagnosis, Delayed diagnosis, Inappropriate treatment. 12/21/2021 MOKSHA'17 11

Diseases clinically presenting with Desquamative gingivitis Dermatological diseases Endocrine disturbances • Cicatricial pemphigoid • • Lichen planus Estrogen deficiencies and in postmenopausal stages • Pemphigus • Testosterone imbalance • Psoriasis • Hypothyroidism • Bullous pemphigoid • Contact stomatitis. • Linear Ig. A disease • Dermatitis herpetiformis • Lupus erythematosus 12/21/2021 Abnormal response to bacterial plaque Chronic infections • Tuberculosis • Chronic candidiasis MOKSHA'17 12

Nikolsky's sign 12/21/2021 MOKSHA'17 13

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