Common Clinical Signs and Phenomena in Oral Diseases

In the diagnosis of oral and maxillofacial diseases, clinicians use specific terms to describe unique physical findings and reactions. Many of these are eponymous signs—named after the physicians who discovered them—that help identify conditions ranging from Pemphigus to Systemic Sclerosis. There are two tables adapted from Clinical Guide to Oral Diseases listing common clinical signs and phenomena, their definitions, and the oral or systemic diseases associated with them.

Table 1: Clinical Signs

Name Clinical findings Diseases
Asboe-Hansen sign Blister spreading with pressure Pemphigus, bullous pemphigoid
Auspitz sign Pin-point bleeding after removal of scales Psoriasis
Barnett’s sign Ridging and tightening of neck Scleroderma
Buttonhole sign Invagination of neurofibromas with pressure Neurofibromatosis-NF1
Crowe’s sign Axillary freckles Neurofibromatosis-NF1
Forchheimer’s sign Petechiae or enanthema on soft palate Infectious mononucleosis; rubella
Gorlin’s sign Tongue touching the nose Ehlers-Danlos syndrome
Meffert’s sign Ectopic sebaceous glands on lips causing a lipstick-like mark left on the rim of a glass mug after consuming a hot beverage Fordyce disease
Nikolsky’s sign Peeling and new bullae formation with rubbing off the unaffected skin or oral mucosa Pemphigus
Reverse Nikolsky’s sign Pseudoepithelial peeling Toxic epidermal necrolysis; staphylococcal scaled skin
Osler’s sign Blue-black sclera Alkaptonuria
Stafne’s sign Widening of the periodontal ligament space Systemic sclerosis

Table 2: Clinical Phenomena

Name Clinical findings Diseases
Bell’s phenomenon Inability to close the affected eye Facial nerve palsy
Brocq’s phenomenon Subepidermal hemorrhage, which occurs on careful scraping of a classical lesion of skin disease Lichen planus
Isotopic phenomenon Occurrence of a different or unrelated dermatological disease at the site of the healed disease (commonly herpes zoster) Herpes zoster
Kasabach-Merrit phenomenon Triad of vascular tumors, thrombocytopenia, and bleeding diathesis. Infantile hemangiomas, Blue rubber bleb nevus
Koebner phenomenon Development a new similar lesions along lines of trauma Psoriasis, lichen planus, vitiligo
Koebner inverse phenomenon A skin condition which inhibits the development of another autoimmune disease Psoriasis and alopecia areata
Koebner remote reverse phenomenon Spontaneous repigmentation is seen in distant patches after autologous skin graft surgery Vitiligo
Koebner reverse phenomenon Clearance of an area of skin disease after trauma Psoriasis
Pathergy phenomenon An erythematous papule of more than 2 mm at the site of a non-specific trauma like pricking with a 20–22-gauge needle Behcet’s disease, Sweet’s syndrome
Raynaud’s phenomenon Episodic changes in blood flow in the cutaneous vasculature in cold weather Connective tissue diseases, Sjogren’s syndrome
Rebound phenomenon Reappearance of a skin disease after stopping steroid treatment Various dermatosis
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