O papel da imunofluorescência direta na fisiopatologia e no diagnóstico diferencial da estomatite aftóide recorrente

Abstract

Recurrent aphthous stomatitis (RAS) is a diseasecharacterized by the periodic appearance of aphthous lesions on the oral mucosa, of which etiology and physiopathology are not well explained. Recent studies with direct immunofluorescence show controversial results. Some reveal that the basic disorder is associated with humoral immunity, while others point to changes in cellular immunity. Atypical forms of aphthous stomatitis may have its differential diagnosis carried out with vesicobullous diseases, such as pemphigus vulgaris. Aim: Check the presence of immunocomplexes in the mucosa of patients with aphthous stomatitis and the usefulness of the differential diagnosis method with bullous skin diseases. Materials and methods: 23 patients with aphthous stomatitis were prospectively included in the study. There were all submitted to mucosa biopsy under local anesthesia for the removal of two fragments. One of these was sent to histology and, the other to direct immunofluorescence. Results: The 23 samples from the histology exam revealed an ulcerated inflammatory process. The samples referred to immunofluorescence resulted negative and only one showed the presence of complement in the basal membrane. Conclusion: Based on our results, we conclude that the patients with RAS do not show deposits of immunocomplexes in their oral cavity mucosa and immunofluorescence is useful in the differential diagnosis between this disease and bullous skin diseases.