Desquamative gingivitis – aetiology, diagnosis and management

Desquamative gingivitis (DG) is a descriptive term, that includes the presence of erythema, desquamation, erosion and blistering of the attached and marginal gingiva.¹ Lesions can be localized (Figure 1), or generalized (Figure 2) and may extend into the alveolar mucosa. Lesions tend to start with diffuse erythema and minimal desquamation. The affected gingival epithelium is very fragile and tends to exfoliate easily, even with the slightest trauma.² Intact vesicles/bullae can occur but usually rupture quickly. Almost all the disorders associated with DG can affect different oral sites and have extra-oral involvement.³ Skin, scalp, nails and mucosa with differentiated epithelium, including laryngeal, oesophageal, nasal, genital and conjunctival, represent possible locations.⁴ Desquamative gingivitis is not considered a definitive diagnosis because it is a clinical manifestation of several disorders. Conditions that are associated with the development of DG generally have a peak of incidence in the 4th to 6th decade of life, with a higher incidence in females than in males.³