Desquamative gingivitis: Clinical and epidemiological findings in patients from Northern Greece

Chatzisymeonidou Soultana, Papadopoulos Petros, Andreadis Dimitrios, Poulopoulos Athanasios

Aristotle University of Thessaloniki, School of Dentistry, Department of Oral Medicine/Pathology, Thessaloniki, Greece

Abstract

Background/Aim: Desquamative gingivitis (DG) is a clinical feature-sign associated with other several mucocutaneous or systemic diseases and disorders. The aim of this research was to present the clinical and epidemiological characteristics (prevalence, age, sex, extend of lesions, coexistence with underlying pathologies) of a cohort of 200 patients from Northern Greece that exhibited clinical appearance of DG. Material and Methods: 200 patients with DG were referred to the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki during the years 2004-2014. The patients were examined clinically, and a biopsy was performed to settle the diagnosis of any possible underlying disease. The epidemiologic parameters being studied were the gender and age, and the investigated clinical characteristics contained the localization of the lesions and the prevalence in relation to coexisting pathologies, habits etc. Statistics were performed by SPSS 22.00 by chi-square test (p= 0,05) and STATA14 program. Results: Clinically, most DGs cases (81%) were accompanied by erosions-vesicles mainly in buccal mucosa (68%), tongue (29, 5%) and lips (27%). The most common underlying disorders were immune-related mucocutaneous diseases including OLP (55,5%) and MMP (29,5%), followed by erythema multiforme (7%), and pemphigus vulgaris (6%). Overall, most patients (76%) had a localized form of DG at the gingiva of anterior teeth. This finding was more prominent in OLP. Interestingly, the diffuse DG form was mostly found in males. Conclusions: DG constitutes an early or the only clinical sign, mostly indicative for immune-related mucocutaneous disorder. Indeed, a properly taken biopsy can validate an earlier diagnosis and treatment. This would be crucial in order to avoid patient’s discomfort and underlying diseases’ complications.

Keywords: desquamative gingivitis; mucocutaneous diseases; oral lichen planus; mucous membrane pemphigoid

Reference

Lo Russo L, Fierro G, Guiglia R, Compilato D, Testa NF, Lo Muzio L, et al. Epidemiology of desquamative gingivitis: evaluation of 125 patients and review of the literature. Int J Dermatol, 2009; 48:1049-1052

Tofan EC, Parlatescu I, Tovaru S, Nicolae C, Preda AS, Funieru C. Desquamative gingivitis-A clinicopathological review. Curr Health Sci J, 2018;44:331-336

Guiglia R, Di Liberto C, Pizzo G, Picone L, Lo Muzio L, Gallo PD, et al. A combined treatment regimen for desquamative gingivitis in patients with oral lichen planus. J Oral Pathol Med, 2007;36:110-116

Karagoz G, Bektas-Kayhan K, Unur M. Desquamative gingivitis: A review. J Istanb Univ Fac Dent, 2016;50:54-60

Paul Grace. Desquamative gingivitis: Does the gingiva tell you more than what meets the eye? A comprehensive review. J Adv Clin Res Insights, 2019;6:48-52

Gagari E, Damoulis PD. Desquamative gingivitis as a manifestation of chronic mucotunaeous disease. J Dtsch Dermatol Ges, 2011;9:184-188

Hasan S. Desquamative gingivitis -A clinical sign in mucous membrane pemphigoid: Report of a case and review of literature. J Pharm Bioallied Sci, 2014;6:122-126

Sciuca AM, Toader MP, Stelea CG, Maftei GA, Ciurcanu OE, Stefanescu OM, et al. Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus-Challenges in the Diagnosis and Treatment. Diagnostics, 2022;12:1754

Robinson NA, Wray D. Desquamative gingivitis: A sign of mucocutaneous disorders-a review. Aust Dent J, 2003;48:206-211

Arduino PG, Broccoletti R, Sciannameo V, Scully C. A practical clinical recording system for cases of desquamative gingivitis. Br J Dermatol, 2017;177:299-301

Willis A, Mullaly B, Irwin C. Desquamative Gingivitis-Aetiology, Diagnosis and Management. Dent Update, 2017;44:564-570

Leao JC, Ingafou M, Khan A, Scully C, Porter S. Desquamative gingivitis: retrospective analysis of disease associations of a large cohort. Oral Dis, 2008;14:556-560

Markopoulos AK, Antoniades D, Papanayotou P, Trigonidis G. Desquamative gingivitis: a clinical, histopathologic, and immunologic study. Quintessence Int, 1996;27:763-767

Sklavounou A, Laskaris G. Frequency of desquamative gingivitis in skin diseases. Oral Surg Oral Med Oral Pathol, 1983;56:141-144

Lo Russo L, Fedele S, Guiglia R, Ciavarella D, Lo Muzio L, Gallo P, et al. Diagnostic Pathways and Clinical Significance of Desquamative Gingivitis. J Periodontol, 2008;79:4-24

Maderal AD, Lee Salisbury P 3rd, Jorizzo JL. Desquamative gingivitis: Clinical findings and diseases. J Am Acad Dermatol, 2018;78:839-848

Bhatia P, Dudhia B, Patel PS, Patel M. Benign mucous membrane pemphigoid. J Ahmedabad Dent Coll Hosp, 2011;2:48-54

Vijayan V, Paul A, Babu K, Madhan B. Desquamative gingivitis as only presenting sign of mucous membrane pemphigoid. J Indian Soc Periodontol, 2016;20:340-343

Siassipour A, Katz J. Oral mucous membrane pemphigoid associated with hypothyroidism: A retrospective study and a case report. Quintessence Int, 2017;48:569-573

Al-Abeedi F, Aldahish Y, Almotawa Z, Kujan O. The Differential Diagnosis of Desquamative Gingivitis: Review of the Literature and Clinical Guide for Dental Undergraduates. J Int Oral Health, 2015;7:88-92

Garcia-Pola MJ, Llorente-Pendás S, Seoane-Romero JM, Berasaluce MJ, García-Martín JM. Thyroid Disease and Oral Lichen Planus as Comorbidity: A Prospective Case-Control Study. Dermatology, 2016;232:214-219

Lin HP, Wang YP, Chía JS, Sun A. Modulation of serum anti-thyroglobulin and anti-thyroid microsomal autoantibody levels by levamisole in patients with oral lichen planus. J Formos Med Assoc, 2011;110:169-174

Chang JY, Chiang CP, Hsiao CK, Sun A. Significantly higher frequencies of presence of serum autoantibodies in Chinese patients with oral lichen planus. J Oral Pathol Med, 2009;38:48-54

Payeras MR, Cherubini K, Figueiredo MA, Salum FG. Oral lichen planus: focus on etio-pathogenesis. Arch Oral Biol, 2013;58:1057-1069

Roopashree MR, Gondhalekar RV, Shashi-kanth MC, George J, Thippeswamy SH, Shuk-la A. Pathogenesis of oral lichen planus -a review. J Oral Pathol Med, 2010;39:729-734

Seyedmajidi M, Shafaee S, Bijani A, Bagheri S. VCAM1 and ICAM1 expression in oral lichen planus. Int J Mol Cell Med, 2013;1:33-40

Guarneri F, Giuffrida R, Di Bari F, Cannavò SP, Benvenga S. Thyroid Autoimmunity and Lichen. Front Endocrinol (Lausanne), 2017;27:8:146

Chang JY, Chiang CP, Wang YP, Wu YC, Chen HM, Sun A. Antigastric parietal cell and antithyroid autoantibodies in patients with desquamative gingivitis. J Oral Pathol Med, 2017;46:307-312

Balkan Journal of Dental Medicine, 2023, vol. 27, br. 3, str. 148-153