Pathology · single question
For pemphigus vulgaris management, each of the following is appropriate EXCEPT one. Which is the EXCEPTION?
Show answer and explanation
Correct answer: B. Prophy jet with abrasive paste
In pemphigus vulgaris, the fragile gingival and oral tissues require GENTLE management. Appropriate treatments include: manual curettage (gentle, controlled), alcohol-free antimicrobial rinses (chlorhexidine without alcohol to avoid irritation), and very careful cavitron use. PROPHY JET with abrasive paste is CONTRAINDICATED — the high-pressure abrasive stream would traumatize the fragile bullous/erosive tissue, extend lesions via Nikolsky sign, and cause significant pain and damage.
- A. INCORRECT (IS appropriate). Manual curettage with gentle technique allows the clinician to control pressure and is appropriate for periodontal maintenance in PV.
- B. CORRECT (this is the EXCEPTION — NOT appropriate). Prophy jet with abrasive paste uses high-pressure air/water/abrasive powder that would severely traumatize PV-affected tissue. The Nikolsky sign means even gentle pressure causes blistering — a prophy jet would be devastating.
- C. INCORRECT (IS an issue but not MOST inappropriate). Cavitron (ultrasonic scaler) can be used CAREFULLY in PV patients, with gentle technique to avoid trauma. However, manual scaling is preferred.
- D. INCORRECT (IS appropriate). Alcohol-free chlorhexidine rinse is appropriate for PV patients — it provides antimicrobial benefit without the irritating effect of alcohol on fragile mucosa.