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Desquamative Gingivitis — MFDS Part 1 MCQ

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ModerateOral MedicineDesquamative GingivitisMFDS Part 1

A 58-year-old woman presents with persistent painful, glazed erythema and epithelial sloughing affecting the attached gingiva. Plaque levels are low, and the lesions have not resolved following oral hygiene measures. Which group contains the conditions most commonly associated with this clinical presentation?

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Correct answer: A — Mucous membrane pemphigoid, pemphigus vulgaris and erosive oral lichen planus

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

A is correct. Desquamative gingivitis is a descriptive clinical presentation rather than a specific diagnosis. Its principal underlying disorders are erosive oral lichen planus, mucous membrane pemphigoid and pemphigus vulgaris. Persistent epithelial sloughing of the attached gingiva despite low plaque levels and oral hygiene measures favours a mucocutaneous disorder. Plaque-induced and necrotising gingivitis do not usually produce this chronic pattern when plaque levels are low. Herpetic disease is generally acute or episodic, nutritional deficiencies cause less specific gingival inflammation or bleeding, and traumatic injuries are usually localised. Clinical appearances overlap, so establishing the underlying diagnosis commonly requires specialist assessment, histopathology and, where an immunobullous disorder is suspected, direct immunofluorescence.

Reference: Staines K, Sims C, Gibb J. Practice Pointer: Assessing oral ulcers and patches in primary care. BMJ. 2026;393:2025-085204. https://www.bmj.com/content/393/bmj-2025-085204.full.pdf