Desquamative Gingivitis: Causes, Classification, and Diagnosis

Desquamative Gingivitis

Write in brief on desquamative gingivitis.
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Classification of Desquamative Gingivitis

• Dermatological:
  • Lichen planus
  • Mucous membrane pemphigoid
  • Bullous pemphigoid
  • Pemphigus vulgaris
  • Chronic ulcerative stomatitis
  • Linear IgA disease
  • Lupus erythematosus

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• Allergic reaction:
  • Dental restorative materials
  • Food (Reaction to oral hygiene products, chewing gum)
  • Drug induced mucocutaneous disorder
• Traumatic lesions:
  • Physical injury
  • Chemical injury
  • Thermal injury
• Miscellaneous conditions

Histopathological Features

• Lesions in desquamative gingivitis can be bullous or lichenoid.
• Bullous lesions show features of mucous membrane pemphigoid while lichenoid type lesions show features like lichen planus.
• Separation of epithelium is seen from underlying connective tissue which starts via the separation of collagen firils.
• Epithelium appears to be atrophic with decrease in the keratinization as well as infiltration of connective tissue with inflammatorycells.

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Chronic Desquamative Gingivitis Diagnosis

Diagnosis is based on the following features, i.e.

• Clinical history: Thorough clinical history should be taken to begin assessment of desquamative gingivitis.
• Clinical examination: Pattern of distribution of lesions, i.e. focal or multifocal, with or without involvement of skin provide information to formulate differential diagnosis.

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• Biopsy: Incisional biopsy should be taken and is sent for microscopic evaluation.
• Immunoflorescence: It is of two type, i.e. direct and indirect. Immunoflorescence test are positive if florescent signal are seen either in epithelium, basement membrane or in connective tissue.