Immunopathological Assessment of the Oral Mucosa in Dermatitis Herpetiformis.

Dermatitis herpetiformis (Duhring's disease, DH) is a chronic blistering cutaneous condition with pruritic polymorphic lesions, consisting of vesicles, papules or nodules and erythema, found predominantly on the extensor surfaces of the limbs, buttocks, and neck. Diagnosis is based on characteristic clinical and immunopathological findings. Oral manifestations of DH have rarely been described. The aim of the study was to evaluate IgA, IgG, IgM and C3 complement deposits in the oral mucosa in DH patients. Direct immunofluorescence (DIF) was performed on the oral mucosa specimens collected from 10 DH patients. Biopsy was taken in a local anesthesia from perilesional site from the buccal mucosa and then preserved in a standard procedure using polyclonal rabbit IgG, IgA, IgM and C3 antibodies. Granular IgA and C3 deposits were found in 6 patients (60%), and in 3 subjects (30%) the result was indeterminate. Significant fluorescence of the deposits along the basement membrane was observed in 2 patients, moderate fluorescence in 3 patients, and in 4 cases the result was indeterminate. C3 deposits were found in 5 subjects (50%), 3 of them being moderate and 2 indeterminate. No IgM and IgG deposits were detected in the collected buccal mucosa specimens.

Scarlet fever - a diagnostic challenge for dentists and physicians: A report of 2 cases with diverse symptoms.

Scarlet fever is an infectious disease caused by group A streptococcal bacteria, transmitted mainly through direct contact with the saliva and nasal fluids of infected people. It may also arise from streptococcal wound infections or burns. The disease most commonly affects children aged 5-15 years and manifests as a sore throat, fever and a sandpaper-like, papular skin rash. Due to the evident involvement of the oral structures, the awareness of the symptoms of scarlet fever is essential for dentists in order to avoid the spread of this highly contagious disease in crowded places, such as kindergartens and schools. As no vaccine is available to prevent scarlet fever, the early diagnosis and treatment of this condition are important in reducing the risk of developing local and systemic complications, which include acute rheumatic fever, glomerulonephritis, bacteremia, pneumonia, endocarditis, and meningitis. In this report, 2 cases of scarlet fever are described in unrelated children with diverse symptoms, and diagnostic and therapeutic strategies are discussed.