Abstract
Desquamative gingivitis (DG) denotes a heterogeneous immune-mediated disease for which early diagnosis represents a great challenge. The main aim of this study is to validate diagnostic concordance between specific Optical Coherence Tomography (OTC) patterns for DG related to oral Lichen Planus (OLP), Pemphigus Vulgaris (PV), and Mucous Membrane Pemphigoid (MMP) and definitive histological diagnosis. Forty-three patients with suspected immune-mediated DGs, were progressively recruited. Before biopsy, an OCT preliminary evaluation was performed using specific pre-determined OCT diagnostic patterns (i.e., morphology and localization of blisters, status of the basal membrane, epithelial thickness, presence/absence of acantholytic cells into blister and/or inflammatory infiltrate) related to OLP, PV and MMP. After histological confirmation, OCT and histological diagnoses were compared. Using pre-determined patterns, OCT diagnoses of DGs were: 22 (51%) OLP, of which 11 (26%) were with the bullous variant, 4 (9%) PV and 6 (14%) MMP. The same diagnoses were found by histological investigations (with the main OCT discriminatory potential for the bullous variant of OLP). The concordance between the two diagnostic methods was confirmed by the Fisher exact test (p-value < 0.01). These specific OCT patterns show a diagnostic reliability in 100% of the cases investigated, suggesting their accuracy to support the complex diagnosis and management of immune-mediated DGs.
Highlights
The main aim of our study is to evaluate the diagnostic concordance between specific diagnostic Optical Coherence Tomography (OCT) patterns of Desquamative gingivitis (DG) related to Oral Lichen Planus (OLP), Pemphigus Vulgaris (PV) and Membrane Pemphigoid (MMP), and a histological confirmatory examination in a cohort of patients with clinical suspected immune-mediated DGs
Forty-three patients with DG potentially related to immune-mediated OLP, MMP
The application of this device on gingival mucosa was facilitated by the non-elasticity of the tissue, reducing one of the main problems related to use of OCT in the oral cavity, and typically represented by altered optical properties induced by the mechanical compression of the oral soft tissue [14]
Summary
Desquamative gingivitis (DG) is a clinical definition to describe an oral condition characterized by erythema, epithelial desquamation, atrophy, ulcerations and/or presence of vesicle-bullous lesions in the gingival mucosa [1]; it denotes a clinical sign of a very large spectrum of diseases with different pathogeneses. Pemphigus Vulgaris (PV), Mucous Membrane Pemphigoid (MMP) and Oral Lichen Planus (OLP), represent about. These immune-mediated diseases could be characterized by muco-cutaneous involvement and chronic course [4]. Almost one third of the patients present primarily
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