Differential diagnosis and treatment protocols for desquamative gingivitis: A systematic review

The occurrence of desquamation, shedding and erythema on marginal and attached gingiva is described as desquamative gingivitis (DG). Various autoimmune/dermatological disorders cause DG.The aim of the present systematic review was to gather information on all possible kinds of treatment for DG, based on specific DG diagnoses.The review was organized following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol. An electronic search was conducted in the PubMed, Scopus and Google Scholar databases, up to April 2022. Reviews, letters and studies with less than 2 participants were excluded.Fifteen publications matched the eligibility criteria: 6 case series; 5 clinical trials; 3 randomized clinical trials (RCTs), and 1 cohort study. A total of 330 patients were enrolled, mostly women (81.52%), with an average age of 57.6 years. Diagnostic characteristics corresponded to oral lichen planus (OLP) (n = 249), mucous membrane pemphigoid (MMP) (n = 30), pemphigus vulgaris (PV) (n = 19), plasma cell gingivitis (PCG) (n = 4), erythema multiforme (EM) (n = 1), and non-specified diseases (NSD) (n = 27). Oral lichen planus and MMP were eliminated using oral hygiene instructions with topical clobetasol and/or doxycycline monohydrate. Pemphigus vulgaris, PCG and EM were treated with topical clobetasol.To conclude, each DG case requires personalized treatment, depending on the diagnosis.