Chronic desquamative gingivitis as part of mucocutaneos manifestations

ABSTRACT

Desquamative gingivitis is a clinical feature of a variety of diseases. In this paper, the clinical features of dermatoses or mucocutaneous disorders where desquamative gingivitis is presenting manifestations have been reviewed [lichen planus, mucous membranes pemphigoid and pemphigus vulgaris]. Other less common mucocutaneous disorders affecting the oral mucosa [lupus erythromatosus, linear IgA, plasma cell gingivitis, chronic ulcerative stomatitis and psoriasis] are also described. Correct identification of these conditions entails taking a careful history and performing a thorough intra-oral examination. Presence of cutaneous, nasal, ocular and genital lesions should be carefully elicited from the patient. The clinical manifestations, investigations and modalities of treatment are reviewed. Desquamative gingivitis [DG] is a clinical feature of a variety of diseases. It is characterised by epithelial desquamation, erythema, ulceration, and/or the presence of vesiculobullous lesions of the gingiva and other oral tissues. This phenomenon can be a manifestation of a number of dermatoses, most commonly lichen planus, mucous membrane pemphigoid [cicatricial pemphigoid], and pemphigus vulgaris [1-3]. Other causes include allergic reactions to toothpastes/mouth rinses [plasma cell gingivitis] [4-6], Crohn's disease [7], psoriasis [8], linear IgA disease [9] and chronic ulcerative stomatitis [10]. Desquamative gingivitis can be mistaken for plaque induced gingivitis and this can lead to delayed diagnosis and inappropriate treatment of serious dermatological diseases such as pemphigoid or pemphigus [11-14]. Desquamative gingivitis as a presenting feature is most commonly noticed in oral lichen planus [OLP] [15-17]