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The oral inflammatory dermatoses is a term used to describe a number of predominantly immune-mediated disorders: lichen planus (LP), erythema multiforme (EM), the vesiculobullous diseases pemphigoid (MMP), pemphigus (PV) and epidermolysis bullosa acquisita (EBA). These conditions are characterized by frequent involvement of the oral mucosa and often associated with extraoral manifestations, particularly of the skin, but can involve the eyes, both the conjunctiva and sclera, the nasal and pharyngeal mucosa, as well as the genitals. Given their frequent, and sometimes initial involvement of the oral mucosa, oral health professionals need to be both familiar with the clinical features and presentations of these conditions, and appreciate their critical role in management.This paper reviews the clinical features and presentation of the oral dermatoses, provides guidance as to the appropriate investigations needed to differentiate and correctly diagnose these conditions, details the aetio-pathology of these diseases and discusses their management.Keywords: Autoimmune, blister, bullae, corticosteroids, dermatoses, desquamative, erosion, immune-mediated, immunosuppression, steroid-sparing, vesicles, vesiculobullous, ulcers.Abbreviations and acronyms: ADCC = antibody dependent cellular cytotoxicity; BMZ = basement membrane zone; CDC = complement dependent cytotoxicity; cGVHD = chronic graft-versus-host disease; DIF = direct immuno-fluorescence; DLE = discoid lupus erythematosus; EB = epidermolysis bullosa; EBA = epidermolysis bullosa acquisita; EM = erythema multiforme; c-IFN = gammainterferon; MMP = mucous membrane pemphigoid; OCP = ocular cicatricial pemphigoid; OLCL = oral lichenoid contact lesions; OLDR = oral lichenoid drug reactions; OLP = oral lichen planus; OMMP = oral mucous membrane pemphigoid; PUVA = psoralen ultraviolet A light; PV = pemphigus vulgaris; SJS = Stevens Johnson syndrome; TEN = toxic epidermal necrolysis; TNF-a = tumour necrosis factor alpha. ORAL LICHEN PLANUSLichen planus is a chronic systemic disease of established immune-mediated pathogenesis.1 It most commonly, and most protractedly, involves the mucosa of the oral cavity, hence it is of interest and concern to dentists, but it can involve other sites, namely the skin, the scalp (with inflammation around and affecting the hair follicles resulting in alopecia), the nails as well as the genital area -the vulval and vaginal mucosa, and the glans penis. There are six recognized oral presentations of lichen planus: (1) reticular; (2) papular; and (3) plaque-form; and the (4) atrophic; (5) ulcerative (erosive) and rare (6) bullous form. These latter three forms can be associated with significant discomfort requiring either topical and ⁄ or systemic immunosuppressive therapy.

Background: Osteomyelitis of the maxillofacial skeleton is rare in developed countries such as Australia. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis (CSO) of the mandible in a 75 year old man. The precipitant factor was thought to be a retained tooth root in the (right) posterior body of the mandible. Methods: Treatment included a pre-surgical course of antibiotics (clindamycin 300mg, p.o. q.i.d. for two weeks) followed by removal of the retained root, surgical débridement of the affected bone, the intra-oral draining sinus, and resection of the cutaneous sinus tract. Specimens were taken for bacterial cultures and antibiotic sensitivity testing, and the resected tissue sent for histopathological review. Results: On clinical and radiographic review at three months, the patient was well, completely symptom free and the osteomyelitis had fully resolved. Conclusion: This case report demonstrates the typical features of CSO. The combination of antibiotic therapy and surgical débridement was effective in the treatment of chronic suppurative osteomyelitis of the mandible utilizing intravenous sedation, and so averting the need for a general anaesthetic.Key words: Osteomyelitis, chronic, surgery, clindamycin, débridement.Abbreviations and acronyms: CSO = chronic suppurative osteomyelitis; p.o. = per oral (by mouth); q.i.d. = quarter in die (four times a day).