Diseases of skin 6 / dental implant courses by Indian dental academy

DISEASES
OF
THE SKIN
SCLERODERMA,
EHLERS-DANLOS SYNDROME
INDIAN DENTAL ACADEMY
LEADER IN CONTINUING DENTAL
EDUCATION
www.indiandentalacademy.com

LEARNING OBJECTIVES
At the end of the lecture student should beAt the end of the lecture student should be
able toable to describe thethe
 Clinical features, Oral manifestations,&
Histopathological features of Scleroderm

SCLERODERMA
It is a complex Multisystem disease
Characterized by progressive diffuse
fibrosis (sclerosis) of the skin &
multiple internal organs, e.g. G I T,
lungs & kidney, etc.

PATHOGENESIS
 Blood circulation insufficiency in the tissue
because of the abnormalities in the arterioles
& blood capillaries.
 Cause replacement of the normal connective
tissue by the dense collagen bundles,results
in the fibrosis, or sclerosis of the tissue.

1)Localized or Morphea form-
Development of one or more, red or ivory
colored, smooth, hard patches on the skin.
Does not have any oral manifestations.
2) Generalized or Diffuse form (more
common type)-
Among children or young adults, frequently
affects the females. More prevalent in areas
where silicosis is a common environmental
hazard

CLINICAL FEATURES
 Begins with edema of the skin over the face,
hands or trunk.
 The affected skin often becomes tight & fixed
firmly to the underlying tissues e.g. muscles and
bones, etc.
 Results in progressive loss of mobility of hands &
joints as well as the movements of the other
internal & external organs.

 Arthritis & arthralgia, along with neuralgia &
paresthesia of the skin.
 With disease progression, the skin becomes
yellow, gray or ivory white in color & shows a
waxy appearance & gradually becomes atrophic,
with areas of pigmentation & calcium
deposition.

 Due to fixation or
induration of the skin,
"wrinkles" (lines of facial
expression) do not form
and as a result a "mask-
like" appearance of the
face and a "claw like"
appearance of the hands
develop.

 Restriction of movements occur in all the voluntary
& involuntary muscles as a result of fibrosis,&
patient becomes completely bed-ridden.
 Dyspnea, dysphagia, loss of vision & difficulty in
speech
 Finally, all the internal organs, e.g. GI tract, heart,
lungs, kidneys, etc. become affected by the fibrosis,
& these organs loose their respective function.

 CREST syndrome is often associated with
scleroderma & it includes the following features.
C- Calcinosis cutis
R- Raynaud's phenomenon
E- Esophageal dysfunction
S- Scleroductyly
T- Telangiectasia.
 Besides this, scleroderma may also coexsist with
some other systemic diseases like- Sjogren's
syndrome, Rheumatoid arthritis, Polymyositis &
Lupus erythematosus, etc.

ORAL MANIFESTATION
 Mostly involves the tongue, cheek, lips, soft
palate & the larynx, etc.
 Varying degrees of trismus & loss of salivary
secretion.
 Oral mucosa shows edema, followed by
atrophy & induration.
 Stiffness of the tongue muscles causes
restricted movements with difficulty in
speech & swallowing.

 Gingival tissue becomes pale and firm.
 Alteration of the fibrous components of gingiva
results in advanced periodontitis.
 Microstomia occurs due to the fixation & rigidity
of the lip muscles.
 Dysphasia due to esophageal strictures.
 Pain, clicking sounds & crepitations in the TMJ.

RADIOLOGICAL FEATURES
 Generalized widening of the periodontal
ligament space.
 Resorption of bone occurs in some areas of
the condyle or ramus of the mandible due to
persistent pressure from the contracting
lesions.

WIDENING OF PDL SPACE

HISTOPATHOLOGY
 Oral epithelium -atrophic with flattening of the
rete ridges.
 Areas of pigmentations
 Thickening & hyalinization of the collagen fibers
in the connective tissue.
 In the early stages, perivascular infiltrates of
mononuclear inflammatory cells are common.

 Blood vessels gradually become scanty & there is
narrowing of the lumen of the remaining vessels
due to the perivascular fibrosis.
 The thickness of the periodontal ligament is
increased due to the increased synthesis of
collagen and oxytalan fibers.
 Sweat glands, sebaceous glands & hair follicles
are often absent in the skin.

SUMMARY
 Introduction, Clinical features, Oral
manifestations,& Histopathological features of
Scleroderma.

BIBLIOGRAPHY
 Text book of oral pathology Shafer's, 5 & 6th
edition
 Oral & Maxillofacial Pathology A Rationale for
Diagnosis & Treatment. R E Marx 1st
edition
 Color Atlas of Oral Diseases Cawson, R. 2nd
& 5th
edition
 Oral and Maxillofacial Pathology Neville, Brad
W. 2nd
 Lucas’s Pathology Of Tumor’s of the Oral Tissues
 Robbins Basic Pathology, Kumar V, A Fausto, 8th
edition
 Lever’s Histopathology of the skin, David Elder
8th
edition

Diseases of skin 6 / dental implant courses by Indian dental academy

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (6)

Similar to Diseases of skin 6 / dental implant courses by Indian dental academy

Similar to Diseases of skin 6 / dental implant courses by Indian dental academy (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

Diseases of skin 6 / dental implant courses by Indian dental academy