Desquamative gingivitis is an erythematous (red), desquamatous (shedding) and ulcerated appearance of the gums.[1] It is a descriptive term and can be caused by several different disorders.[2]
| Desquamative gingivitis | |
|---|---|
| Other names | DG |
| Specialty | Periodontology  |
Signs and symptoms
editDesquamative gingivitis involves lesions of the free and attached gingiva. Unlike plaque-induced inflammation of the gums (normal marginal gingivitis), desquamative gingivitis extends beyond the marginal gingiva, involving the full width of the gingiva and sometimes the alveolar mucosa.[3] The term "full width gingivitis" usually refers to the oral lesions of orofacial granulomatosis however.[4] The color is another dissimilarity between typical marginal gingivitis and desquamative gingivitis, in the latter it is dusky red.[3] Plasma cell gingivitis is another form of gingivitis which affects both the attached and free gingiva.[1]
Cause
editCaused by various autoimmune diseases as well as allergies. Erosive lichen planus, mucous membrane pemphigoid, pemphigus vulgaris, erythema exsudativum multiforme and lupus erythematosus.
Diagnosis
editDifferential diagnosis
editDesquamative gingivitis is a descriptive clinical term, not a diagnosis.[1] Dermatologic conditions cause about 75% of cases of desquamative gingivitis, and over 95% of the dermatologic cases are accounted for by either oral lichen planus or cicatricial pemphigoid.[1] The exact cause of desquamative gingivitis cannot be determined about a third of cases.[1]
- Oral lichen planus[1]
- Cicatricial pemphigoid[1] or less commonly bullous pemphigoid[1]
- Pemphigus vulgaris[1]
- Linear immunoglobulin A disease[1]
- Dermatitis herpetiformis[1]
- Lupus erythematosus[1]
- Chronic ulcerative stomatitis[1]
- Chronic bacterial, fungal, and viral infections[1]
- Reactions to medications, mouthwashes, and chewing gum[1]
Rare causes include:
- Crohn's disease[1]
- Sarcoidosis[1]
- Leukemia[1]
- factitious (self inflicted) lesions[1]
- Squamous cell carcinoma (can be mistaken for desquamative gingivitis)[1]
Treatment
edit- Improving oral hygiene
- Minimising irritation of the lesions
- Specific therapies for the underlying disease (where available)
- Local or systemic immunosuppressive or dapsone therapy (notably not corticosteroids)
History
editThis condition was first recognized and reported in 1894, but the term desquamative gingivitis was not coined until 1932.[1]
References
edit- ^ a b c d e f g h i j k l m n o p q r s t u Newman, Michael G.; Takei, Henry H.; Carranza, Fermín A., eds. (2012). Carranza's clinical periodontology (11th ed.). St. Louis, Mo: Elsevier/Saunders. pp. 111–126. ISBN 978-1-4377-0416-7.
- ^ Lo Russo, L; Fedele, S; Guiglia, R; Ciavarella, D; Lo Muzio, L; Gallo, P; Di Liberto, C; Campisi, G (January 2008). "Diagnostic pathways and clinical significance of desquamative gingivitis". Journal of Periodontology. 79 (1): 4–24. doi:10.1902/jop.2008.070231. PMID 18166088.
- ^ a b Odell, E. W., ed. (2010). Clinical problem solving in dentistry. Clinical problem solving in dentistry series (3rd ed.). Edinburgh ; New York: Churchill Livingstone. p. 192. ISBN 978-0-443-06784-6. OCLC 427608817.
- ^ Welbury R; Duggal M; Hosey MT (2012). Welbury, Richard; Duggal, Monty S.; Hosey, Marie Thérèse (eds.). Paediatric dentistry (4th ed.). Oxford: Oxford University Press. p. 319. ISBN 978-0-19-957491-9.