[Chronic desquamative gingivitis syndrome: retrospective analysis of 33 cases]

Abstract

Objective: Desquamative gingivitis is a chronic diffuse inflammation of the gingiva. The aim of this study was to determine the causes and the clinical characteristics of desquamative gingivitis.

Patients and methods: This was a retrospective descriptive study including 33 consecutive patients (25 women and 8 men) seen at a dermatology clinic for erosive gingivitis.

Results: Thirteen patients (39 p. 100) had cicatricial pemphigoid, 12 (36 p. 100) had lichen planus, and 5 (15 p. 100) had pemphigus. Delay to diagnosis was a mean 19 months. The pinch sign was positive in 12 of the 13 cases of cicatricial pemphigoid. Dapsone improved the buccal lesions of cicatricial pemphigoid in all cases. Systemic corticosteroid therapy and acitretine were the most effective treatments for lichen planus and corticosteroid therapy improved pemphigus in all cases. At the time of assessment, only 3 cases of cicatricial pemphigoid, 2 cases of lichen planus and 1 case of pemphigus had reached complete remission without treatment.

Discussion: Cicatricial pemphigoid and lichen planus are the most frequent causes of desquamative gingivitis, accounting for three-quarters of the cases. Positive diagnosis may be difficult and may require sophisticated techniques to avoid delay. Despite the effectiveness of symptomatic treatment, desquamative gingivitis may have a long course.