Dermatology & Oral Disease Laith Akkash M.D Consultant Dermatologist, Dermasurgeon & Allergist Assistant professor of Dermatology Jordan University Hospital University of Jordan

Dermatology Its relationship with oral diseases Histology of the Skin Histology of the mucous membranes Functions of mucous membranes Types of mucous membranes in the oral cavity

Stratified squamous epithelium May or may not be keratinized Lamina propria is the underlying C.T. layer Submucosa Salivary glands

Oral mucosa can be subdivided into: 1-Masticatory mucosa: keratinized stratified squamous epithelium, found on the dorsum of the tongue, hard palate and attached gingiva.keratinizedstratified squamous epitheliumdorsumtonguehard palategingiva 2- Lining Mucosa: non-keratinized stratified squamous epithelium, found almost everywhere else in the oral cavitystratified squamous epithelium 3- Specialized mucosa: specifically in the regions of the taste buds on the dorsum of the tonguetaste buds

Relatively common disorders that may affect the mucous membranes 1) Infections 2) Bullous diseases 3) Connective tissue diseases 4) Allergic conditions 5) Benign & Malignant tumors 6) Genodermatosis 7) other skin diseases

1) Infections A)Viral infections: - Herpes Simplex - Herpes Zoster - Hand foot & mouth disease - Warts –HPV - HIV- Oral hairy leukoplakia

Cold sores

1ry herpes simplex

Oral warts

Oral hairy leukoplakia

Hand foot & mouth disease

1) Infections contd. B) Bacterial: - 1ry Syphilis - 2ry Syphilis - Gonococcal pharyngitis & Tonsillitis - Actinomycosis - TB - Leprosy

1ry syphilitic chancre

2ry syphilis – mucous patch

Gonorrhea

Gonoccocal pharyngitis

1) Infections contd. C) Fungal infections: - Candidiasis - Histoplasmosis

Oral Thrush - Candidiasis

Relatively common disorders that may affect the mucous membranes 1) Infections 2) Bullous diseases 3) Connective tissue diseases 4) Allergic conditions 5) Benign & Malignant tumors 6) Genodermatosis 7) other skin diseases

2) Bullous diseases -Pemphigus vulgaris -Bullous pemphigoid -Cicatricial pemphigoid -Linear IgA disease

Pemphigus vulgaris

Relatively common disorders that may affect the mucous membranes 1) Infections 2) Bullous diseases 3) Connective tissue diseases 4) Allergic conditions 5) Benign & Malignant tumors 6) Genodermatosis 7) other skin diseases

3) Connective tissue diseases -Systemic lupus erythematosus -Progressive systemic scleroderma

Systemic Lupus Erythematosus

Relatively common disorders that may affect the mucous membranes 1) Infections 2) Bullous diseases 3) Connective tissue diseases 4) Allergic conditions 5) Benign & Malignant tumors 6) Genodermatosis 7) other skin diseases

4) Allergic conditions -Fixed drug eruption -Allergic contact stomatitis -Angioedema

Angioedema

Relatively common disorders that may affect the mucous membranes 1) Infections 2) Bullous diseases 3) Connective tissue diseases 4) Allergic conditions 5) Benign & Malignant tumors 6) Genodermatosis 7) other skin diseases

5) Benign & Malignant Tumors Benign -Naevi -Fibromas -Granular cell tumor -Hemangiomas -Lymphangiomas -Leiomyomas -Pyogenic granulomas Malignant -Squamous cell ca. -Malignant melanoma -Sarcomas -Lymphomas

SCC lip

SCC -Ventral tongue

Relatively common disorders that may affect the mucous membranes 1) Infections 2) Bullous diseases 3) Connective tissue diseases 4) Allergic conditions 5) Benign & Malignant tumors 6) Genodermatosis 7) other skin diseases

6) Genodermatosis -Epidermolysis Bullosa -Darier’s disease

Epidermolysis Bullosa

Relatively common disorders that may affect the mucous membranes 1) Infections 2) Bullous diseases 3) Connective tissue diseases 4) Allergic conditions 5) Benign & Malignant tumors 6) Genodermatosis 7) other skin diseases

7) Others -Lichen Planus -Behcet Disease -Aphthous ulcers -Fordyce disease -Mucocele -Angular cheleitis -White sponge naevus -Tongue diseases

Lichen Planus

Oral LP

Aphthous ulcers