BackgroundTo evaluate the diagnostic patterns and factors that may influence delays in the diagnosis of pemphigus vulgaris (PV) with oral involvement.Materials and MethodsIn this prospective cohort study, 36 newly diagnosed PV patients with oral involvement were clinically examined and interviewed about the natural history of the oral lesions, number of medical consultations (Med consultation), medical treatment history, and diagnostic delay time (DD time).ResultsThirty (83%) PV patients presented initially with oral mucosal involvement (OMI) and 6 (17%) presented initially with skin involvement (SI). The mean DD time was 6.19 ± 3.82 months, and the mean number of Med consultation was 5.8 (n = 36). The means of all the parameters were significantly higher for the OMI patients than for the SI patients (P < .05). All of the patients with OMI had been misdiagnosed. The DD time was significantly longer in patients who presented initially with desquamative gingivitis (8.25 ± 3.81) than patients who presented with ulcers and erosions (4.78 ± 1.11) (P < .05). There was a statistically significant positive correlation between DD time and Med consultation (r = 0.91).ConclusionEven with the high frequency of oral involvement and easy access to the oral cavity, diagnostic delays are still common for patients with oral PV. This underlines the need for education to improve healthcare providers' awareness and knowledge of the clinical oral presentation of PV.
Objectives: Several mucocutaneous diseases are responsible for desquamative gingivitis (DG) and diagnostic delays are common in these diseases due to non-specific clinical oral presentations. The present study aimed to analyze the clinical features of DG-related mucocutaneous diseases with oral manifestations and compare the findings with previous reports. Materials and Methods:Thirty newly diagnosed patients with oral mucocutaneous disease in the Dermatology and Venereology Department of Akdeniz University Medical School, between January 2018 and January 2020, and referred to the Periodontology Department for periodontal treatment were evaluated retrospectively. Patients' demographic data (age and gender), medical comorbidities, primary lesion site (oral or skin), and clinical features of gingival and oral lesions (location and symptoms) were examined.Results: There were 18 oral lichen planus (OLP), 8 pemphigus vulgaris (PV), and 4 mucous membrane pemphigoid (MMP) patients with oral involvements. The mean age of the patients was 50.03 ± 9.71 years with a female predominance (male to female ratio 1:1.7). All patients suffered from chronic burning sensation and oral pain. DG was detected in all three mucocutaneous diseases but OLP was the main disease associated with DG (60%). However other oral mucosal lesions and extraoral involvements were more frequent in PV patients. Conclusions:According to these results, OLP, MMP, and PV are the mucocutaneous diseases responsible for DG, and OLP is the most common cause of DG. Clinicians should be familiar with the clinical presentations and signs (patient complaints) of DG-related mucocutaneous disease for early diagnosis, proper treatment, and quality of life of the patient.
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