robbypowell's version from 2017-05-04 00:03

Muco-cutaneous & Immune-mediated Disorders

Question Answer
What condition is usually seen as a red or white lesion in posterior cheek adjacent to an old amalgam?Lichenoid Contact Stomatitis
List 3 drugs that are common causes of Lichenoid Drug Reactions (painful ulcerations)NSAID's, Anti-HTN (diuretics), & Anti-malarials
Lichen Planus is associated with Hepatitis _____Hep C
____ ______ is a common skin condition with oral lesions appearing as reticular, erosive or plaque-like, cobweb appearance condition. It is an example of cell-mediated immune condition. Lichen Planus
The pathogenesis of Lichen Planus is due to sub epithelial ____ cell infiltration that leads to destruction of the _____ cell layerT-cell; basal Cell Layer
In Lichen Planus, an environmental antigen stimulates ______ cells that present antigen to immune system... this stimulates CD___ & CD___ cells which destroy basal cells.Langerhans cells (APC); CD4 & CD8
Oral Lichen Planus is seen in ____% of the population. With ___% of cases manifesting on skin and in the mouth, ____% in just the mouth and ___% only on skin2%; 40%; 25% 35%
A histo-slide of epithelial tissue with saw-tooth like morphology of rete-ridges, band-like lymphocytic infiltration at basal cell layer and inferior to is, fibrinogen deposits but no IG's would indicate what condition?Lichen Planus
WICHKHAM's STRIAE are white streaks on mucosa with a cobweb appearance that are signs of what condition?Lichen Planus ((Reticular type)
"Desquamative Gingivitis" can be what cell-mediated non-neoplastic condition?Erosive Lichen Planus
______ type of Lichen Planus can look like proliferative Leukoplakia, PVL, or candidaPlaque
What forms of lichen Planus would you need to biopsy and which one would you not?Erosive & Plaque Lichen Planus
T/F: Lichen Planus is pre-malignantFalse (but SCC carcinoma might occur in areas that had LP on them)
What is the biggest cue that a condition is Lichenoid Epithelial Dysplasia, as opposed to Lichen PlanusThe dysplasia with lichenoid involvement is usually uni-focal , while LP is more generalized
<_________ % of erosive Lichen Planus cases might progress to epithelial dysplasia<1%
How is Erosive Lichen Planus treated? (effective in 90% of patients)Topical Corticosteroid
What is the "prototypical example of autoimmune disease"?Lupus Erythematosus
Lichen Planus-like lesion on the upper lip is likely to be what autoimmune condition?Lupus
this is a chronic autoimmune blistering disease of mucosal surfaces cause by auto-antibodies against anchoring protein of hemidesmosomes (BP180 or BP2) results in sub-epithelial cleating with preservation of the basal cell layerBenign Mucous Membrane Pemphigoid
histo-slide where epi-is sloughing off, no lichenoid band noted, no linear IgG deposits noted, basal layer intactBenign Mucous Membrane Pemphigoid
What is a positive Nikolsky's sign?mechanical rubbing on seemingly normal mucosa causes vesiculo-bullous sloughing (associated with Erosive Lichen Planus, BMMP, & Pemphigus Vulgaris)
What condition is the most common cause of Desquamative Gingivitis (which is clinical sign, not a disease)BMMP (pemphigoid)
Autoimmune disease with chronic blistering caused by antibodies (IgG, IgM IgA) against intracellular desmosomes (desmoglein 1 & 3) result in supra basal epithelial separation (basal cell layer still attached to CT)Pemphigus
Erythema multiform is an acute intermittent version that resembles _________, but is caused by a hypersensitivity reactionPemphigus
Positive Nikolsky's sign, Bull's eye/iris lesions that has NO gingival desquamationErythema Multiform
_____ ______ ______ is an severe version of Erythema MultiformToxic Epidermal Necrosis
this condition is an autoimmune disease where fibroblasts get stimulated and deposit collagen in skin, mouth, and visceral organsProgressive Systemic Sclerosis (Systemic Scleroderma)
What does CREST syndrome stand for?Calcinosis of skin (calcified plaques) Reynaud disease (low blood flow to fingers and toes) Esophageal strictures, Sclerodactyly, Teleangiectasia
What are the Oral/Facial symptoms of Scleroderma/Systemic Scleroderma?Mask-like face, Restricted mouth opening (tongue mobility and dysphagia), Xerostomia, Advanced Periodontitis
Erosion of mandibular angles, excess collagen, and symmetric widening of PDL spaces are all signs of what condition?Scleroderma (systemic) (aka PSS)
Does PSS have a good or poor prognosis?Poor prognosis
The common feature of all forms of PemphigusAcantholysis
In _____ _____, acantholysis selectively involves the layer of cells immediately above the basal cell layer, giving rise to a suprabasal acantholytic blisterPemphigus Vulgaris
Cellular Infiltrate in Pemphigus?Lymphocytes, Macrophages, Eosinophils
Blistering in ____ ____ is triggered by the linear deposition of IgG antibodies and complement in the epidermal basement membraneBullous Pemphigoid
2 Treatments for Bullous PemphigoidCorticosteroids & Immunosuppressants
Which Chronic Autoimmune Dermatosis results in loss of dermo-epidermal adhesion because IgG antibodies to Collagen type 17?Bullous Pemphigoid
In Bullous Pemphigoid.... the antigen, ______, is recognized by the ______ antibody (immunoglobulin)Collagen type 17; IgG
IgE-______ Urticaria is associated with reactions to Pollen, food, venom, drugsIgE Dependent
IgE-______ Urticaria is associated with reactions to Opiates & antibioticsIndependent
IgG bound to the surface of Keratinocytes is diagnostic for what condition?Pemphigus Vulgaris
Pemphigus Vulgaris affects: (A) Skin, (B) Mucosa, (C) Skin & MucosaSkin & Mucosa
Most common form of PemphigusPemphigus Vulgaris
Pemphigus Vulgaris is an ______ disease... this in response to a protein expressed in _____Autoimmune; Desmosomes
Autoimmune condition causing Suprabasal acantholysisPemphigus Vulgaris
Pemphigus Vulgaris and Bullous Pemphigoid both have autoimmune causes involving which type antibody?IgG
Bullous Pemphigoid is an autoimmune response to collagen in the _____ _____Basement membrane
excessive fibrosis in multiple tissues, obliterative vascular disease, and the production of multiple autoantibodiesSystemic Sclerosis (aka Scleroderma)
body develops autoantibodies against adhesion molecules, specifically ones located in hemidesmosomesMucous Membrane Pemphigoid
auto-immune condition with specific autoantibodies agains BP-230, BP-180, Laminin, and Beta4 IntegrinMucous Membrane Pemphigoid
vesicles, ulcers and bullae in mouth; symblepharon & inverted eye-lidsMucous Membrane Pemphigoid
Nikolsky signMucous Membrane Pemphigoid
Bullae without Nikolsky signBullous Pemphigoid
viral infection assoc with lichen planus & erythema multiformeHepatitis C virus
caused by antibodies against hemidesmosomes in basement membraneMucous Membrane Pemphigoid