• The Journal of the Korean dental association
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• v.52 no.12
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• pp.726-733
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• 2014

The gingiva consists of an epithelial layer and an underlying connective tissue layer. The oral epithelium is a keratinized, stratified, squamous epithelium. The epithelium can be divided into the following cell layer: basal layer, prickle cell layer, granular cell layer and keratinized cell layer. The desquamative disease of gingiva means exfoliative diseases of epithelial layer on the gingiva. The chronic desqumative gingivitis is usually related to the dematologic disorders that produce cutaneous and mucous membrane blisters. The cicatricial pemphigoid and lichen planus are representative diseases of the dermatologic cases. Patients may be asymptomatic or symptomatic. When symptomatic, their complaints range from a mild burning sentation to an severe pain. The clinical examination must be considered with a thorough history, and routine histologic and immunofluorescence studies. A systemic approach needs to achieve accurate diagnosis and treatment of the gingival desquamative diseases.

• Journal of Oral Medicine and Pain
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• v.26 no.2
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• pp.121-126
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• 2001

Mucous membrane pemphigoid is uncommom disease in oral cavity and synonymous with cicatricial pemphigoid. This disease is caused by autoimmune reaction that autoantibody reacts antigen located in basement membrane and epithelium is separated from underlying connective tissue. It affects female over sixth decade, commonly. Oral mucosa, especially gingiva is common site but conjunctival, nasal, pharyngeal, laryngeal, esophageal, varginal mucosa and skin are involved. Intraoral findings show Nikolsky sign, irregular erythema, erosion, vesicle, and ulceration at mucous membrane. To differentiate from diseases of positive Nikolsky sign, should perform histologic, immunologic test. Histologic features show subbasilar cleft and direct immunologic features show IgG, C3 deposits at basement membrane in linear pattern. Mucous membrane pemphigoid is incurable disease because symptoms are repetitively improved or worsed for several years. Patiens are commonly managed with topical and systemic steroid. To avoid side effects of prolonged steroid therapy and to maintain immunosupressive effects, combination therapy of azathioprine with steroid is effective. This case reports that mucous membrane pemphigoid is diagnosed based on clinical and histologic features, is treated with topical, systemic steroid and azathioprine therapy.

• Journal of Periodontal and Implant Science
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• v.30 no.3
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• pp.631-639
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• 2000

Desquamative gingivitis is characterized by a diffuse erythema of the free and attached gingiva associated with areas of vesiculation, erosion, and desquamation. Desquamative gingivitis is not a distinct disease entity but represents a reaction pattern of the gingiva to various stimuli. Pemphigus vulgaris, cicatricial pemphigoid, and lichen planus may presents as desquamative gingivitis. We observed 3 patients whose disease was limited to the gingiva, and studied them by light and direct immunofluorescence microscope. We classified them according to clinical, histologic, and immunopathologic observations. Identification of the underlying causes of desquamative gingivitis is of utmost importance and is dependent upon clinical, histologic, and immunologic criteria.