Desquamative gingivitis - Oral Mucosal Lesion
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Synopsis

Patients affected by desquamative gingivitis will frequently experience intense discomfort and may have difficulty eating and drinking. Lesions typically arise along the buccal aspect of the gingiva, most commonly in a diffuse pattern. However, lesions have been reported to occur at any site along the gingiva.
If the desquamative gingivitis is a manifestation of mucous membrane pemphigoid, pemphigus vulgaris, or paraneoplastic pemphigus, the patient may develop extra-oral involvement in other sites, most commonly the nasal or anogenital mucosa, larynx, esophagus, skin, and conjunctiva.
Codes
ICD10CM:K05.11 – Chronic gingivitis, non-plaque induced
SNOMEDCT:
22208002 – Desquamative gingivitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Primary herpes simplex gingivostomatitis (see orofacial herpes simplex virus) – These patients have a fever, acute disease onset, and shallow ulcers involving not only the gingiva but other intraoral sites. No desquamation is seen.
- Chronic ulcerative stomatitis – Resembles erosive lichen planus. Other oral mucosal sites are typically involved as well. Requires direct immunofluorescence (DIF) studies to confirm diagnosis.
- Plasma cell gingivitis – Red, enlarged gingivae, but no desquamation.
- Dermatitis herpetiformis – Rare intraoral involvement. Would not be seen without characteristic skin lesions.
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References
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Last Reviewed:05/02/2021
Last Updated:05/02/2021
Last Updated:05/02/2021