By Richard C.K. Jordan, Michael A.O. Lewis
A accomplished consultant to prognosis and therapy of oral problems;superb color illustrations built-in all through - combining some great benefits of an atlas with a brief text/reference;symptoms-based approach;one situation in keeping with web page or web page spread.
content material: PREFACE; ACKNOWLEDGEMENTS; ABBREVIATIONS; 1 advent; 2 ULCERATION; three BLISTERS; four WHITE PATCHES; five ERYTHEMA; 6 SWELLING; 7 PIGMENTATION (INCLUDING BLEEDING); eight OROFACIAL soreness (INCLUDING SENSORY AND MOTOR DISTURBANCE); nine DRY MOUTH, extra SALIVATION, covered TONGUE, HALITOSIS, and adjusted flavor; INDEX.
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Extra info for A Colour Handbook of Oral Medicine
The cause of lichen planus is not known, although it is immunologically mediated and resembles, in many ways, a hypersensitivity reaction to an unknown antigen. T-lymphocyte-mediated destruction of basal keratinocytes and hyperkeratinization produces the characteristic clinical lesions. CLINICAL FEATURES Lichen planus presents as white patches or striae that may affect any oral site, typically with a symmetric and bilateral distribution. Clinical appearance is variable and at least six forms have been described: reticular (126–129); papular; plaque-like (130); atrophic (131, 132); erosive (133, 134); and (rare) bullous.
The oral mucosa is involved initially in about 50% of cases of pemphigus vulgaris, and indeed oral involvement can precede involvement at other sites. Most cases are pemphigus vulgaris since pemphigus vegetans is extremely rare. DIAGNOSIS Attempts to demonstrate Nikolsky’s sign (mucosa lifting from the underlying connective tissue on pressure) should be resisted due to the production of further lesions. Diagnosis is best confirmed by biopsy of an intact or recently ruptured bulla. Formalin fixed tissue should be sent for routine histopathology and fresh tissue should be sent for direct immunofluorescence.
CLINICAL FEATURES Although the clinical presentation of lichenoid reactions is characteristically seen as widespread irregular white patches (Chapter 4, p. 64), on occasions the mucosa may be extensively ulcerated (67) with sloughing (68, 69). MANAGEMENT If the patient is taking a medicine known to be associated with the occurrence of lichenoid lesions, consideration should be given to a change of therapy to a structurally unrelated drug with similar therapeutic effect. Resolution of the mucosal lesions usually follows within a few weeks (Chapter 4, p.
A Colour Handbook of Oral Medicine by Richard C.K. Jordan, Michael A.O. Lewis