Preface: Oral Manifestations of Systemic Diseases xiii
Joel J. Napeñas
Introduction to Oral Manifestations of Systemic Diseases: Evaluation of the Patient 85
Mary Hil Edens, Yasser Khaled, and Joel J. Napeñas
History of present condition and medical history 85
Source and reliability 85
Chief complaint 85
History of present illness 85
Past medical, family, and social history 86
Occupational and environmental history 86
Review of systems 86
Examination 86
Vital signs 86
General evaluation 86
Cranial nerve examination 86
American Society of Anesthesiologists classification of physical status 86
Head and neck examination 87
Imaging studies 88
Intraoral radiographs 88
Three-dimensional imaging 88
Diagnostic tests and studies 90
Urinalysis 91
Blood testing 91
Smear and culture 91
Biopsy 92
Oral Manifestations of Gastrointestinal Disorders 93
Lina Maria Mejia
Introduction 93
Gastroesophageal reflux disease 93
Medical management 94
Oral manifestations and considerations 94
Inflammatory bowel disease 95
Ulcerative colitis 95
Crohn’s disease 97
Liver disease 99
General overview 100
Manifestations of liver disease 100
Oral manifestations and considerations 101
Summary 102
Oral Manifestations of Immunodeficiencies and Transplantation Medicine 105
Elizabeth Waring and Alessandro Villa
Introduction 105
Early effects 105
Mucositis 105
Infection 106
Late effects 108
Malignancy 108
Graft versus host disease (lichenoid, xerostomia) 108
Postinflammatory hypermelanosis 109
Neutropenic ulcer 109
Drug-related effects 109
Drug-induced gingival hyperplasia 109
Mammalian target of rapamycin inhibitor–associated stomatitis 110
Other effects 110
Oral Manifestations of Autoimmune and Connective Tissue Disorders 113
Vidya Sankar and Marcel Noujeim
Introduction 113
Autoimmune and autoinflammatory-related blistering and ulcerative diseases 113
Pemphigus vulgaris 113
Mucous membrane pemphigoid 116
Oral lichen planus 117
Behçet disease 117
Connective tissue diseases 119
Systemic lupus erythematosus 119
Sjögren syndrome 120
Rheumatoid arthritis 123
Sarcoidosis 123
Drug-Induced Oral Complications 127
Kentaro Ikeda
Drug-induced oral complications 127
Drug-induced angioedema 127
Brief description 127
Incidence, predilection 127
Clinical features 127
Differential diagnosis 127
Treatment considerations 128
Erythema multiforme 128
Brief description 128
Incidence, predilection 128
Clinical features 128
Differential diagnosis 129
Histopathology 129
Treatment considerations 129
Drug-induced gingival hyperplasia 129
Brief description 129
Incidence, predilection 129
Clinical features 129
Differential diagnosis 129
Histopathology 130
Treatment considerations 130
Newer evolving medications, biologics 130
Brief description 130
Incidence/clinical features 130
Differential diagnosis 130
Treatment considerations 131
Oral Complications of Nonsurgical Cancer Therapies 133
Sharon Elad, Yehuda Zadik, and Noam Yarom
Introduction 133
Oral mucosal complications 133
Salivary gland complications 136
Musculoskeletal complications 138
Sensory disturbances 141
Teeth and gingivae 142
Bleeding 144
Infections: bacterial, viral, and fungal 144
Malignancy 145
Developmental disturbances of teeth and craniofacial growth occur in pediatric patients. 146
Summary 146
Oral Manifestations of Hematologic Disease 149
Christina McCord and Lisa Johnson
Introduction 149
White blood cell disorders 149
Lymphoma 149
Multiple myeloma 151
Leukemia 152
Neutropenia 154
Red blood cell disorders 154
Iron deficiency anemia 155
Pernicious anemia 155
Sickle cell anemia 156
Thalassemia 157
Histiocytic disorders: Langerhans cell histiocytosis 157
Bleeding disorders 159
Thrombocytopenia 159
Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) 160
Hemophilia 160
Oral Manifestations of Viral Infections 163
Mahnaz Fatahzadeh
Introduction 163
Herpes simplex type 163
Description 163
Epidemiology 163
Primary oral herpes 163
Secondary oral herpes 164
Varicella-zoster virus 165
Varicella zoster (chicken pox) 165
Herpes zoster (shingles) 165
Description 165
Clinical presentation 165
Differential diagnosis 166
Coxsackievirus infections 166
Description 166
Epidemiology 166
Clinical presentation 166
Diagnosis 167
Management 167
Human papillomavirus 167
Description 167
Natural history 168
Clinical presentation 168
Oral Manifestations of Immunologically Mediated Diseases 171
Lisa Johnson, Kristina Perschbacher, Iona Leong, and Grace Bradley
Introduction 171
Swellings 171
Orofacial granulomatosis 171
Ulcers 173
Recurrent aphthous stomatitis 173
Behçet disease 177
Erythema multiforme 178
Red and white lesions 181
Lichen planus 181
Oral lichenoid lesions 182
Lichenoid contact reaction to dental materials, particularly amalgam 182
Contact stomatitis—cinnamon reaction 184
Oral Complications of Multiorgan Disorders 187
Leah Bowers and Michael Brennan
Amyloidosis 187
Brief description 187
Clinical features 187
Incidence, predilection, genetics 187
Histopathology 188
Differential diagnoses 188
Treatment considerations 188
Sarcoidosis including Heerfordt syndrome 188
Brief description 188
Incidence, predilection, genetics 188
Clinical features 189
Histopathology 189
Differential diagnosis 189
Treatment considerations 190
Granulomatosis with polyangiitis 190
Brief description 190
Incidence, predilection, genetics 190
Clinical features 190
Histopathology 190
Differential diagnosis 191
Treatment considerations 191
IgG4-related disease 191
Brief description 191
Prevalence, predilection, genetics 191
Presenting features 191
Histopathology 191
Differential diagnoses 191
Treatment considerations 192
Systemic sclerosis (systemic scleroderma) including CREST syndrome 192
Brief description 192
Incidence, predilection, genetics 192
Clinical features 192
Histopathology 193
Differential diagnosis 193
Treatment considerations 193
Head and Neck Manifestations of Endocrine Disorders 197
Arwa M. Farag
Introduction 197
Pituitary gland disorders 197
Hypopituitarism 197
Hyperpituitarism 198
Treatment considerations 198
Thyroid gland disorders 199
Hypothyroidism 199
Hyperthyroidism 199
Parathyroid gland disorders 201
Hyperparathyroidism 201
Hypoparathyroidism 202
Adrenal glands disorders 202
Adrenocortical insufficiency or hypoadrenocorticism (Addison disease) 202
Hyperadrenocorticism (Cushing syndrome) 202
Endocrine pancreatic disorders 204
Etiology and epidemiology 204
Clinical manifestations 204
Treatment considerations 204
Pregnancy 204
Etiology 204
Oral manifestations during pregnancy 205
Consideration during dental management of pregnant women 205
Oral Complications of Systemic Bacterial and Fungal Infections 209
Amr Bugshan, Arwa M. Farag, and Bhavik Desai
Introduction 209
Bacterial infections 209
Tuberculosis 209
Bacterial salivary gland infection 210
Syphilis 211
Actinomycosis 213
Cat-scratch disease 215
Uncommon bacterial infections associated with oral manifestations 215
Fungal infections 216
Oral candidiasis 216
Deep fungal infections 217
Oral Complications of Dermatologic Disorders 221
Paolo G. Arduino
Introduction 221
Oral lichen planus 221
Mucous membrane pemphigoid 223
Pemphigus vulgaris 224
Epidermolysis bullosa 224
Psoriasis 226
