Chronic desquamative gingivitis as part of mucocutaneous 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].

Sudanese Journal of Dermatology Vol. 4(1) 2006: 16-27