Diagnosis and Management of Desquamative Gingivitis

Endo, Hiroyasu; Rees, Terry D.

doi:10.5772/22864

Cited by 10 publications

(11 citation statements)

References 65 publications

(140 reference statements)

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“…Desquamative gingivitis (DG) is a condition characterized by painful erythematous gingiva not resulting from dental plaque, sloughing of gingival tissues, erosions and ulcerations of the gingival epithelium and bulla formation on the gingiva [23][24][25][26]. It is a clinical manifestation common to several diseases or disorders [23][24][25][26]. Most DG patients are caused by mucocutaneous diseases.…”

Section: Introductionmentioning

confidence: 99%

“…MMP is responsible for 35-48% and PV for 3-15% of DG [26]. Contact allergic reactions to various oral hygiene products, dental materials, or food flavoring and preservatives have also been reported in the differential diagnosis of DG [23,24]. Gingival desquamation is a prominent clinical feature, and Nikolsky's sign often shows a positive reaction in DG caused by autoimmune bullous diseases [21].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, histopathological examination and direct immunofluorescence (DIF) testing are often required to establish the final diagnosis [24]. The specific disease or disorder causing DG, the severity of the DG lesions, the presence or absence of extraoral lesions, and the medical history of the patient are the key factors in determining the selection of a topical or systemic treatment [10,23,24]. In some patients, DG can be successfully managed with moderate to very high-potency topical corticosteroids combined with effective plaque control.…”

Section: Introductionmentioning

confidence: 99%

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Desquamative Gingivitis: Early Sign of Mucous Membrane Pemphigoid and Pemphigus Vulgaris

Endo¹,

Rees²,

Niwa³

et al. 2019

Periodontology and Dental Implantology

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Early signs and symptoms of autoimmune bullous diseases such as mucous membrane pemphigoid (MMP) or pemphigus vulgaris (PV) develop in the oral cavity in almost all cases. Desquamative gingivitis (DG) is a clinical manifestation common to several diseases or disorders and is frequently associated with autoimmune bullous diseases. This is a retrospective study of 37 patients with MMP (24 cases) or PV (13 cases) including 10 males and 27 females with a mean age of 58.4 years. The study indicates that DG is an early sign of autoimmune bullous diseases such as MMP or PV. About 70.3% of the oral lesions were confined only to the gingiva, and DG was the only manifestation of the diseases. Since some lesions remain limited to the oral cavity for a long period of time, patients diagnosed with MMP or PV should be closely followed because they must be immediately referred to other experts when they develop lesions on parts of their body other than the oral cavity. The oral healthcare provider should collaborate with other healthcare experts including dermatologists, ophthalmologists, and otolaryngologists to evaluate and manage patients with autoimmune bullous diseases in the oral cavity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Desquamative Gingivitis: Early Sign of Mucous Membrane Pemphigoid and Pemphigus Vulgaris

Endo¹,

Rees²,

Niwa³

et al. 2019

Periodontology and Dental Implantology

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“…Although it rarely occurs, PV is a life‐threatening condition if left untreated, so it is important to diagnose and treat it in its early stages. Oral lesions are the most common early evidence of the disease and will ultimately develop in almost all patients with untreated PV (Endo et al, ; Endo, Rees, Hallmon, et al, ; Endo & Rees, ). Occasionally, the gingiva is the only site involved in the early lesions, and desquamative gingivitis is a relatively common manifestation of the disease (Endo et al, ; Endo & Rees, ; Endo, Rees, Hallmon, et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Oral lesions are the most common early evidence of the disease and will ultimately develop in almost all patients with untreated PV (Endo et al, ; Endo, Rees, Hallmon, et al, ; Endo & Rees, ). Occasionally, the gingiva is the only site involved in the early lesions, and desquamative gingivitis is a relatively common manifestation of the disease (Endo et al, ; Endo & Rees, ; Endo, Rees, Hallmon, et al, ). Gingival Nikolsky's sign showed a positive reaction in more than 90% of the cases that were diagnosed as PV based on oral lesions (Mignogna et al, ).…”

Section: Introductionmentioning

confidence: 99%

Acantholysis may precede elevation of circulating anti‐desmoglein 3 antibody levels in pemphigus vulgaris presenting with desquamative gingivitis

Endo

Rees²,

Niwa

et al. 2019

Clinical & Exp Dental Res

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Pemphigus vulgaris (PV) is an autoimmune, blistering disease that affects the mucosa and skin. The current theory favors the concept that anti‐desmoglein (Dsg) 3 autoimmunity is the only pathogenic event needed to induce acantholysis. However, a few cases of active PV in the oral cavity had no detectable anti‐Dsg 3 antibody. The aim of this study was to evaluate the differences in clinical and laboratory findings, whether or not the anti‐Dsg 3 antibodies were present. This study was based on a retrospective review of 10 PV cases. The evaluation of the circulating autoantibody titers to Dsg 3 was conducted by using enzyme‐linked immunosorbent assay (ELISA). An index value of 20 or more was used as the cutoff for a positive reaction. Only five of the 10 PV cases had a positive Dsg 3 ELISA. There were no differences in clinical, cytological, histopathological, and direct immunofluorescence findings, whether or not the anti‐Dsg 3 antibodies were present. Of the five patients with a negative reaction at the time of diagnosis, the Dsg 3 ELISA became positive in the follow‐up period in three cases. In the remaining two cases, the Dsg 3 ELISA was consistently negative for 18 months. Dsg 3 ELISA was negative early in some PV cases. Therefore, PV acantholysis may precede the elevation of circulating anti‐Dsg 3 antibody levels. The diagnosis of PV should be considered based on comprehensive clinical, histopathological, and immunofluorescent criteria.

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Menopausal Desquamative Gingivitis - A Diagnostic Challenge

Hr¹,

Shenoy²

2020

jemds

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Diagnosis and Management of Desquamative Gingivitis

Cited by 10 publications

References 65 publications

Desquamative Gingivitis: Early Sign of Mucous Membrane Pemphigoid and Pemphigus Vulgaris

Desquamative Gingivitis: Early Sign of Mucous Membrane Pemphigoid and Pemphigus Vulgaris

Acantholysis may precede elevation of circulating anti‐desmoglein 3 antibody levels in pemphigus vulgaris presenting with desquamative gingivitis

Menopausal Desquamative Gingivitis - A Diagnostic Challenge

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