Pathology · single question

For a patient with active pemphigus who has painful oral lesions and a positive Nikolsky sign, what should be AVOIDED during a routine dental cleaning?

Use of an air-polishing/prophy-jet device with abrasive powder, which can mechanically trigger new bullae/erosions
Use of an ultrasonic scaler
Hand/manual instrumentation
Use of an alcohol-free rinse

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Correct answer: A. Use of an air-polishing/prophy-jet device with abrasive powder, which can mechanically trigger new bullae/erosions

Friable mucosa in pemphigus exhibits a positive Nikolsky sign — minor mechanical trauma can induce new blister/erosion formation. Abrasive air-polishing devices pose a particular risk and should be avoided in favor of gentler instrumentation, with extra care taken regardless of method.

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For a patient with active pemphigus who has painful oral lesions and a positive Nikolsky sign, what should be AVOIDED during a routine dental cleaning?

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