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López-Pintor RM, González-Serrano J, Ivaylova Serkedzhieva K, Serrano Valle J, de Arriba L, Hernández G, Sanz M. Gingival hypersensitivity reactions to toothpastes: A case series and scoping review. J Am Dent Assoc 2024; 155:213-226.e3. [PMID: 38206258 DOI: 10.1016/j.adaj.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/29/2023] [Accepted: 11/10/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Hypersensitivity reactions to toothpastes are rare. The objective of this study was to present the authors' clinical cases in the past 10 years and perform a scoping review of gingival hypersensitivity responses to toothpastes. TYPES OF STUDIES REVIEWED The authors reviewed records of documented gingival hypersensitivity reactions to dentifrices at the Postgraduate Clinic of Oral Medicine, Complutense University, Madrid, Spain, from January 2013 through December 2022. Furthermore, the authors conducted a search in PubMed with no date limit for articles reporting these hypersensitivity responses up through October 18, 2023. RESULTS Eleven cases were collected from the clinic. Eight gingival hypersensitivity reactions occurred in women, and 6 were associated with cinnamon. The most frequent lesions diagnosed were red gingiva. The discontinuation of the toothpaste led to the disappearance of the lesions. The search yielded 643 references. Thirteen articles were included in the scoping review, all of them case series and case reports, reporting 32 cases. Lesions affected middle-aged women most frequently, the most common hypersensitivity reaction was gingival redness, and the cases implicated toothpastes containing cinnamon and herbal composition. PRACTICAL IMPLICATIONS This study provides clues for diagnosing and treating hypersensitivity reactions to toothpastes, which may improve the identification, management, and reporting of these cases.
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2
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Patil S, Khan SS, Hosmani J, Khan ZA, Muruganandhan J, Mushtaq S, Yadalam PK, Bhandi S, Awan KH. Identification of oral immune disorders- A review and a diagnostic algorithm. Dis Mon 2023; 69:101350. [PMID: 35337656 DOI: 10.1016/j.disamonth.2022.101350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Immunological disorders are observed in various clinical presentations in the oral cavity. The pathophysiology of these disorders include but are not limited to primary oral auto-immune disease, systemic disease with oral findings, malignancies, hypersensitivity reactions, drug-induced, and infection-related. Many of these disorders have overlapping oral features, making it difficult for the clinician to diagnose and treat the disorder. There is a need to provide a simple and practical decision-making algorithm to the clinicians and provide them guidance on laboratory investigations. The present review provides a diagnostic algorithm that might minimize outpatient process delays and lead to early management. This is crucial in many cases where oral findings may be the first sign of the disorder, and early treatment can preclude dissemination and complications of the disorder.
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Affiliation(s)
- Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia; Department of Maxillofacial Surgery & Diagnostic Sciences, Division. of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Samar Saeed Khan
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division. of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Jagadish Hosmani
- Oral Pathology Division, Department of Diagnostic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Zafar Ali Khan
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Jayanandan Muruganandhan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India
| | - Shazia Mushtaq
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia
| | - Pradeep Kumar Yadalam
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600 077, India
| | - Shilpa Bhandi
- Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, United States.
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3
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Abstract
Oral and craniofacial tissues are uniquely adapted for continuous and intricate functioning, including breathing, feeding, and communication. To achieve these vital processes, this complex is supported by incredible tissue diversity, variously composed of epithelia, vessels, cartilage, bone, teeth, ligaments, and muscles, as well as mesenchymal, adipose, and peripheral nervous tissue. Recent single cell and spatial multiomics assays-specifically, genomics, epigenomics, transcriptomics, proteomics, and metabolomics-have annotated known and new cell types and cell states in human tissues and animal models, but these concepts remain limitedly explored in the human postnatal oral and craniofacial complex. Here, we highlight the collaborative and coordinated efforts of the newly established Oral and Craniofacial Bionetwork as part of the Human Cell Atlas, which aims to leverage single cell and spatial multiomics approaches to first understand the cellular and molecular makeup of human oral and craniofacial tissues in health and to then address common and rare diseases. These powerful assays have already revealed the cell types that support oral tissues, and they will unravel cell types and molecular networks utilized across development, maintenance, and aging as well as those affected in diseases of the craniofacial complex. This level of integration and cell annotation with partner laboratories across the globe will be critical for understanding how multiple variables, such as age, sex, race, and ancestry, influence these oral and craniofacial niches. Here, we 1) highlight these recent collaborative efforts to employ new single cell and spatial approaches to resolve our collective biology at a higher resolution in health and disease, 2) discuss the vision behind the Oral and Craniofacial Bionetwork, 3) outline the stakeholders who contribute to and will benefit from this network, and 4) outline directions for creating the first Human Oral and Craniofacial Cell Atlas.
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Affiliation(s)
- A J Caetano
- Centre for Craniofacial and Regenerative Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - I Sequeira
- Institute of Dentistry, Barts Centre for Squamous Cancer, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London, UK
| | - K M Byrd
- Lab of Oral and Craniofacial Innovation, Department of Innovation and Technology Research, ADA Science and Research Institute, Gaithersburg, MD, USA
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4
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Oral mucous membrane pemphigoid in a group of Thai patients–A 15–year retrospective study. J Dent Sci 2021; 17:1009-1017. [PMID: 35756789 PMCID: PMC9201646 DOI: 10.1016/j.jds.2021.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/22/2022] Open
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5
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Williams DW, Greenwell-Wild T, Brenchley L, Dutzan N, Overmiller A, Sawaya AP, Webb S, Martin D, Hajishengallis G, Divaris K, Morasso M, Haniffa M, Moutsopoulos NM. Human oral mucosa cell atlas reveals a stromal-neutrophil axis regulating tissue immunity. Cell 2021; 184:4090-4104.e15. [PMID: 34129837 PMCID: PMC8359928 DOI: 10.1016/j.cell.2021.05.013] [Citation(s) in RCA: 178] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/10/2021] [Accepted: 05/10/2021] [Indexed: 12/21/2022]
Abstract
The oral mucosa remains an understudied barrier tissue. This is a site of rich exposure to antigens and commensals, and a tissue susceptible to one of the most prevalent human inflammatory diseases, periodontitis. To aid in understanding tissue-specific pathophysiology, we compile a single-cell transcriptome atlas of human oral mucosa in healthy individuals and patients with periodontitis. We uncover the complex cellular landscape of oral mucosal tissues and identify epithelial and stromal cell populations with inflammatory signatures that promote antimicrobial defenses and neutrophil recruitment. Our findings link exaggerated stromal cell responsiveness with enhanced neutrophil and leukocyte infiltration in periodontitis. Our work provides a resource characterizing the role of tissue stroma in regulating mucosal tissue homeostasis and disease pathogenesis.
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Affiliation(s)
- Drake Winslow Williams
- Oral Immunity and Inflammation Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Teresa Greenwell-Wild
- Oral Immunity and Inflammation Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Laurie Brenchley
- Oral Immunity and Inflammation Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nicolas Dutzan
- Oral Immunity and Inflammation Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA; Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Andrew Overmiller
- Laboratory of Skin Biology, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD 20892, USA
| | - Andrew Phillip Sawaya
- Laboratory of Skin Biology, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD 20892, USA
| | - Simone Webb
- Biosciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Daniel Martin
- Genomics and Computational Biology Core, National Institute on Deafness and Other Communication Disorders, Bethesda, MD 20892, USA
| | - George Hajishengallis
- University of Pennsylvania, Penn Dental Medicine, Department of Basic and Translational Sciences, Philadelphia, PA 19104, USA
| | - Kimon Divaris
- UNC Adams School of Dentistry and Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Maria Morasso
- Laboratory of Skin Biology, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD 20892, USA
| | - Muzlifah Haniffa
- Biosciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton CB10 1SA, UK; Department of Dermatology and NIHR Newcastle Biomedical Research Centre, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4LP, UK
| | - Niki Maria Moutsopoulos
- Oral Immunity and Inflammation Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA.
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6
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Gomez-Casado C, Sanchez-Solares J, Izquierdo E, Díaz-Perales A, Barber D, Escribese MM. Oral Mucosa as a Potential Site for Diagnosis and Treatment of Allergic and Autoimmune Diseases. Foods 2021; 10:970. [PMID: 33925074 PMCID: PMC8146604 DOI: 10.3390/foods10050970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022] Open
Abstract
Most prevalent food allergies during early childhood are caused by foods with a high allergenic protein content, such as milk, egg, nuts, or fish. In older subjects, some respiratory allergies progressively lead to food-induced allergic reactions, which can be severe, such as urticaria or asthma. Oral mucosa remodeling has been recently proven to be a feature of severe allergic phenotypes and autoimmune diseases. This remodeling process includes epithelial barrier disruption and the release of inflammatory signals. Although little is known about the immune processes taking place in the oral mucosa, there are a few reports describing the oral mucosa-associated immune system. In this review, we will provide an overview of the recent knowledge about the role of the oral mucosa in food-induced allergic reactions, as well as in severe respiratory allergies or food-induced autoimmune diseases, such as celiac disease.
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Affiliation(s)
- Cristina Gomez-Casado
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Javier Sanchez-Solares
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Elena Izquierdo
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - Araceli Díaz-Perales
- Center of Plant Biotechnology and Genomics, Technical University of Madrid, 28040 Madrid, Spain;
| | - Domingo Barber
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
| | - María M. Escribese
- Institute of Applied Molecular Medicine, Department of Basic Medical Sciences, Faculty of Medicine, San Pablo CEU University, 28003 Madrid, Spain; (J.S.-S.); (E.I.); (D.B.); (M.M.E.)
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7
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Dommisch H, Stolte KN, Jager J, Vogel K, Müller R, Hedtrich S, Unbehauen M, Haag R, Danker K. Characterization of an ester-based core-multishell (CMS) nanocarrier for the topical application at the oral mucosa. Clin Oral Investig 2021; 25:5795-5805. [PMID: 33821321 PMCID: PMC8443517 DOI: 10.1007/s00784-021-03884-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/11/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Topical drug administration is commonly applied to control oral inflammation. However, it requires sufficient drug adherence and a high degree of bioavailability. Here, we tested the hypothesis whether an ester-based core-multishell (CMS) nanocarrier is a suitable nontoxic drug-delivery system that penetrates efficiently to oral mucosal tissues, and thereby, increase the bioavailability of topically applied drugs. MATERIAL AND METHODS To evaluate adhesion and penetration, the fluorescence-labeled CMS 10-E-15-350 nanocarrier was applied to ex vivo porcine masticatory and lining mucosa in a Franz cell diffusion assay and to an in vitro 3D model. In gingival epithelial cells, potential cytotoxicity and proliferative effects of the nanocarrier were determined by MTT and sulphorhodamine B assays, respectively. Transepithelial electrical resistance (TEER) was measured in presence and absence of CMS 10-E-15-350 using an Endohm-12 chamber and a volt-ohm-meter. Cellular nanocarrier uptake was analyzed by laser scanning microscopy. Inflammatory responses were determined by monitoring pro-inflammatory cytokines using real-time PCR and ELISA. RESULTS CMS nanocarrier adhered to mucosal tissues within 5 min in an in vitro model and in ex vivo porcine tissues. The CMS nanocarrier exhibited no cytotoxic effects and induced no inflammatory responses. Furthermore, the physical barrier expressed by the TEER remained unaffected by the nanocarrier. CONCLUSIONS CMS 10-E-15-350 adhered to the oral mucosa and adhesion increased over time which is a prerequisite for an efficient drug release. Since TEER is unaffected, CMS nanocarrier may enter the oral mucosa transcellularly. CLINICAL RELEVANCE Nanocarrier technology is a novel and innovative approach for efficient topical drug delivery at the oral mucosa.
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Affiliation(s)
- H Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14197, Berlin, Germany. .,Department of Periodontology, University of Washington, Seattle, WA, USA.
| | - K N Stolte
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14197, Berlin, Germany
| | - J Jager
- Institute for Biochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany
| | - K Vogel
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14197, Berlin, Germany
| | - R Müller
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14197, Berlin, Germany
| | - S Hedtrich
- Pharmacology and Toxicology, Institute of Pharmacy, Freie Universität Berlin, 14195, Berlin, Germany.,Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T1Z3, Canada
| | - M Unbehauen
- Institute for Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - R Haag
- Institute for Chemistry and Biochemistry, Freie Universität Berlin, 14195, Berlin, Germany
| | - K Danker
- Institute for Biochemistry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117, Berlin, Germany
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8
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Abualgasim AOB, Yousif YO. Oral mucosal disorders of inpatients with mucocutaneous diseases from Khartoum, Sudan. Oral Dis 2020; 27 Suppl 3:733-736. [PMID: 32585746 DOI: 10.1111/odi.13511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 06/12/2020] [Accepted: 06/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Yousif Osman Yousif
- Department of OMFS, Faculty of Denistry, Unversity of Khartoum (U of K), Khartoum, Sudan
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9
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Al Ismaili A, Al Busaidi K, Nalawade T, Saraf S. Immune-mediated Skin Disorders and their Oral Manifestations in the Omani Population: A Hospital-based Study. Oman Med J 2020; 35:e84. [PMID: 32042465 PMCID: PMC6976739 DOI: 10.5001/omj.2020.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/25/2019] [Indexed: 01/01/2023] Open
Abstract
Objectives We sought to determine the prevalence of immune-mediated skin disorders (IMDs), their oral manifestations, and the related comorbidity among Omani patients with IMDs attending the outpatient Department of Dermatology and Dental Clinic at Al Nahdha Hospital, Muscat. Methods We conducted a retrospective study of 236 newly-diagnosed patients with IMDs who attended the outpatient clinic between September 2014 and September 2017. Data, such as age, sex, investigations, diagnosis, comorbidity, and associated oral manifestations of the affected individuals, were collected from the hospital health information system. Results Of the 236 diagnosed cases of IMD, lichen planus substantially comprised over half of the total cases (59.7%). This was followed by relatively fewer cases of discoid lupus erythematosus (11.0%), systemic lupus erythematosus (10.2%), and erythema multiforme (8.1%). Pemphigus vulgaris and bullous pemphigus comprised only 3.0% and 4.2% of the total studied cases, respectively. The other less common disorders found in our study were toxic epidermal necrolysis (1.7%), pemphigus foliaceus (1.3%), and gestational pemphigoid (0.8%). Oral mucosal involvement was seen more commonly with lichen planus (78.7%), pemphigus vulgaris (71.4%), and erythema multiforme (75.0%), while systemic lupus erythematosus and discoid lupus erythematosus were shown to appear with more comorbidities compared to the other skin disorders studied. Conclusions Several IMDs have considerable oral involvement. These oral manifestations of the diseases may be overlooked by other specialists leading to a delay in the diagnosis and its management. In order to circumvent this delay, the analysis and evaluation of a disease need to be done by a team comprising of a dental surgeon, dermatologist, and an oral medicine specialist.
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Affiliation(s)
| | - Khalid Al Busaidi
- Dermatology Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Triveni Nalawade
- Department of Pediatric Dentistry, Oman Dental College, Muscat, Oman
| | - Sanjay Saraf
- Oral Basic Sciences, Oman Dental College, Muscat, Oman
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10
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Epidermolysis bullosa acquisita: A comprehensive review. Autoimmun Rev 2019; 18:786-795. [DOI: 10.1016/j.autrev.2019.06.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 02/07/2023]
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11
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Pietkiewicz P, Bowszyc-Dmochowska M, Gornowicz-Porowska J, Dmochowski M. Involvement of Nail Apparatus in Pemphigus Vulgaris in Ethnic Poles Is Infrequent. Front Med (Lausanne) 2018; 5:227. [PMID: 30155468 PMCID: PMC6102408 DOI: 10.3389/fmed.2018.00227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/25/2018] [Indexed: 11/21/2022] Open
Abstract
Pemphigus vulgaris lesions have a tendency to localize around natural body orifices. The aim here was to analyze the involvement of nail apparatus in pemphigus vulgaris. Sixty seven ethnic Poles suffering from pemphigus vulgaris on photographic files archiving initial presentation were retrospectively evaluated. Pemphigus vulgaris was diagnosed using combination of clinical data, H+E histology, direct immunofluorescence of plucked scalp hair and/or perilesional tissue also for IgG1 and IgG4 deposits evaluation, indirect immunofluorescence on mosaic substrate and/or monkey esophagus, mono-analyte ELISA with desmoglein 1/3 or multi-analyte ELISA. The nail apparatus involvement was found in 9 of 67 patients (13.4%; 3 females and 6 males). Periungual fingernail lesions were found in 6 patients (2 females, 4 males), whereas periungual toenail lesions in just 3 patients (1 female, 2 males). Our patients nail apparatus changes included, by order of frequency, paronychia, nail discoloration, onychorrhexis, Beau lines, periungual hemorrhages, onychomadesis, cross-ridging, onycholysis, and trachyonychia. The average time between the onset, as recalled by patients, and the diagnosis of pemphigus vulgaris with direct immunofluorescence was not statistically different in PV patients with and without nail apparatus lesions. In this article the molecular and immunological rationale for of periungual involvement is discussed. Our single-center study suggests that nail apparatus involvement is infrequent in pemphigus vulgaris in ethnic Poles. Due to the fact that nail apparatus lesions in pemphigus vulgaris may clinically resemble onychomycosis, giving the proper diagnosis can be difficult particularly when other lesions are overlooked or misinterpreted.
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Affiliation(s)
- Pawel Pietkiewicz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
- Surgical Oncology and General Surgery Clinic I, Greater Poland Cancer Center, Poznan, Poland
| | | | | | - Marian Dmochowski
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
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12
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From HSV infection to erythema multiforme through autoimmune crossreactivity. Autoimmun Rev 2018; 17:576-581. [PMID: 29635075 DOI: 10.1016/j.autrev.2017.12.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 12/24/2017] [Indexed: 12/26/2022]
Abstract
Scientific and clinical data indicate that human herpes simplex virus 1 (HSV1) and, at a lesser extent, human herpes simplex virus 2 (HSV2) are factor(s) implicated in the development of erythema multiforme (EM). With a focus on oral EM, the present structured review of proteomic and epitope databases searched for the molecular basis that might link HSV1 and HSV2 infections to EM. It was found that a high number of peptides are shared between the two HSVs and human proteins related to the oral mucosa. Moreover, a great number of the shared peptides are also present in epitopes that have been experimentally validated as immunopositive in the human host. The results suggest the involvement of HSV infections in the induction of oral EM via a mechanism of autoimmune cross-reactivity and, in particular, highlight a potential major role for 180kDa bullous pemphigoid antigen and HSV1 infection in the genesis of crossreactions potentially conducive to EM.
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13
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Baglama Š, Trčko K, Rebol J, Miljković J. Oral manifestations of autoinflammatory and autoimmune diseases. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2018. [DOI: 10.15570/actaapa.2018.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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Hambly JL, Haywood A, Hattingh L, Nair RG. Comparison between self-formulation and compounded-formulation dexamethasone mouth rinse for oral lichen planus: a pilot, randomized, cross-over trial. ACTA ACUST UNITED AC 2016; 8. [PMID: 27344987 DOI: 10.1111/jicd.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/22/2016] [Indexed: 12/26/2022]
Abstract
AIM There is a lack of appropriate, commercially-available topical corticosteroid formulations for use in oral lichen planus (OLP) and oral lichenoid reaction. Current therapy includes crushing a dexamethasone tablet and mixing it with water for use as a mouth rinse. This formulation is unpleasant esthetically and to use in the mouth, as it is a bitter and gritty suspension, resulting in poor compliance. Thus, the present study was designed to formulate and pilot an effective, esthetically-pleasing formulation. METHODS A single-blinded, cross-over trial was designed with two treatment arms. Patients were monitored for 7 weeks. Quantitative and qualitative data was assessed using VAS, numeric pain scales, the Treatment Satisfaction Questionnaire for Medication-9, and thematic analysis to determine primary patient-reported outcomes, including satisfaction, compliance, quality of life, and symptom relief. RESULTS Nine patients completed the pilot trial. Data analysis revealed the new compounded formulation to be superior to existing therapy due to its convenience, positive contribution to compliance, patient-perceived faster onset of action, and improved symptom relief. CONCLUSION Topical dexamethasone is useful in the treatment of OLP. When carefully formulated into a compounded mouth rinse, it improves patient outcomes.
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Affiliation(s)
- Jessica L Hambly
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Alison Haywood
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Laetitia Hattingh
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Pharmacy, Curtin University, Perth, WA, Australia
| | - Raj G Nair
- School of Dentistry, Oral Health, Oral Medicine and Oral Oncology, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Haematology and Oncology, Gold Coast University Hospital, Gold Coast, QLD, Australia
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15
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Reichart PA, Schmidt-Westhausen AM, Khongkhunthian P, Strietzel FP. Dental implants in patients with oral mucosal diseases - a systematic review. J Oral Rehabil 2015; 43:388-99. [DOI: 10.1111/joor.12373] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2015] [Indexed: 01/27/2023]
Affiliation(s)
- P. A. Reichart
- Department of Oral Medicine, Dental Radiology and Oral Surgery; Center for Dental, Oral and Maxillary Medicine; Charité - Universitätsmedizin Berlin/Germany; Berlin Germany
| | - A. M. Schmidt-Westhausen
- Department of Oral Medicine, Dental Radiology and Oral Surgery; Center for Dental, Oral and Maxillary Medicine; Charité - Universitätsmedizin Berlin/Germany; Berlin Germany
| | - P. Khongkhunthian
- Faculty of Dentistry; Center of Excellence for Dental Implantology; Chiang Mai University/Thailand; Chiang Mai Thailand
| | - F. P. Strietzel
- Department for Oral Medicine, Dental Radiology, and Oral Surgery; Charité Centre 3 for Dental, Oral, and Maxillary Medicine; Charité - Universitätsmedizin Berlin; Berlin Germany
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Mustafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmun Rev 2015; 14:930-51. [PMID: 26117595 DOI: 10.1016/j.autrev.2015.06.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023]
Abstract
A group of autoimmune diseases is characterised by autoantibodies against epithelial adhesion structures and/or tissue-tropic lymphocytes driving inflammatory processes resulting in specific pathology at the mucosal surfaces and the skin. The most frequent site of mucosal involvement in autoimmune diseases is the oral cavity. Broadly, these diseases include conditions affecting the cell-cell adhesion causing intra-epithelial blistering and those where autoantibodies or infiltration lymphocytes cause a loss of cell-matrix adhesion or interface inflammation. Clinically, patients present with blistering, erosions and ulcers that may affect the skin as well as further mucosal surfaces of the eyes, nose and genitalia. While the autoimmune disease may be suspected based on clinical manifestations, demonstration of tissue-bound and circulating autoantibodies, or lymphocytic infiltrates, by various methods including histological examination, direct and indirect immunofluorescence microscopy, immunoblotting and quantitative immunoassay is a prerequisite for definitive diagnosis. Given the frequency of oral involvement and the fact that oral mucosa is the initially affected site in many cases, the informed practitioner should be well acquainted with diagnostic and therapeutic aspects of autoimmune dermatosis with oral involvement. This paper reviews the pathogenesis and clinical presentation of these conditions in the oral cavity with a specific emphasis on their differential diagnosis and current management approaches.
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Affiliation(s)
- Mayson B Mustafa
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; Oral medicine section, Department of Oral and Maxillofacial Surgery, University of Khartoum, Faculty of Dentistry, Khartoum, Sudan
| | | | - Bruce R Smoller
- Department of Pathology, University of Rochester, School of Medicine and Dentistry, USA
| | - Cassian Sitaru
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; BIOSS Centre for Biological Signalling Studies, Signalhaus Freiburg, Schänzlestr. 18, 79104 Freiburg, Germany.
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Ojaimi S, O'Connor K, Lin MW, Schifter M, Fulcher DA. Treatment outcomes in a cohort of patients with mucosal-predominant pemphigus vulgaris. Intern Med J 2015; 45:284-92. [DOI: 10.1111/imj.12674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 12/17/2014] [Indexed: 01/16/2023]
Affiliation(s)
- S. Ojaimi
- Department of Clinical Immunology; Westmead Hospital; Sydney New South Wales Australia
| | - K. O'Connor
- Department of Clinical Immunology; Westmead Hospital; Sydney New South Wales Australia
| | - M. W. Lin
- Department of Clinical Immunology; Westmead Hospital; Sydney New South Wales Australia
- Department of Medicine; The University of Sydney; Sydney New South Wales Australia
| | - M. Schifter
- Department of Medicine; The University of Sydney; Sydney New South Wales Australia
- Oral Medicine/Oral Pathology Unit; Westmead Hospital; Sydney New South Wales Australia
| | - D. A. Fulcher
- Department of Clinical Immunology; Westmead Hospital; Sydney New South Wales Australia
- Department of Medicine; The University of Sydney; Sydney New South Wales Australia
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Autoimmune blistering diseases in females: a review. Int J Womens Dermatol 2015; 1:4-12. [PMID: 28491949 PMCID: PMC5418673 DOI: 10.1016/j.ijwd.2015.01.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 10/23/2014] [Accepted: 01/13/2015] [Indexed: 12/31/2022] Open
Abstract
The autoimmune blistering diseases (AIBDs) are a group of heterogeneous skin diseases with autoantibodies directed against structural proteins in the skin. A new interest in the female bias towards autoimmune diseases in general has led to our attention to focus on how and why this female bias manifests in AIBD. The authors aim to review and explore the various aspects of AIBD affecting females more than males, including the higher prevalence, worse quality of life, and complex management issues such as pregnancy and lactation. What is already known on this topic? Echoing autoimmune diseases in general, most autoimmune blistering diseases (AIBDs) have a female predominance, but the exact level of predominance is unknown. Pregnancy raises several complicated management issues for females with an AIBD.
What does this article add to our knowledge? Review of sex-specific epidemiology and etiology of each AIBD. Exploration and explanation of the key factors underlying the detrimental impacts of AIBD on women’s quality of life (QOL). Discussion of management issues in pregnancy and lactation for females with an AIBD.
How does this information impact clinical practice and/or change patient care? An awareness and understanding of the female predominance in AIBDs will ensure more appropriate diagnosis, evaluation, and future research. Emphasizing holistic care targeting the debilitating effects of AIBDs on women’s QOL. Informing the reader of optimal, yet safe interventions for pregnant women with an AIBD.
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Abstract
We report a case of a 51-year-old woman with a history of type II diabetes mellitus and dyslipidemia presenting with pain, swelling, and crusting of the lips. One year after onset of mucosal lesions, she developed an abdominal eruption with several tense vesicles and bullae on an erythematous base. The hematoxylin and eosin stain sample was consistent with a diagnosis of pemphigus vulgaris. The tense bullae of our patient highlight a rare phenotype of pemphigus vulgaris, which fits the mucocutaneous type because of involvement of the oral mucosa, with the exception of the findings of tense bullae.
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Affiliation(s)
- Emilie T Nguyen
- Student at Loma Linda University School of Medicine in Loma Linda, CA.
| | - Shinko K Lin
- Dermatology Resident at the Los Angeles Medical Center in CA.
| | - Jashin J Wu
- Director of Dermatology Research for the Department of Dermatology at the Los Angeles Medical Center in CA.
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