Estudo epidemiológico das doenças dermatológicas imunologicamente mediadas na cavidade oral

Abstract

▲An epidemiological study of immune-mediated skin diseases affecting the oral cavity * Estudo epidemiológico das doenças dermatológicas imunologicamente mediadas na cavidade oral Abstract: BACKGROUND: Immune-mediated skin diseases encompass a variety of pathologies that present in different forms in the body. OBJECTIVE: The objective of this study was to establish the prevalence of the principal immune-mediated skin diseases affecting the oral cavity. METHODS: A total of 10,292 histopathology reports stored in the archives of the Anatomical Pathology Laboratory, Department of Oral Pathology, Federal University of Rio Grande do Norte, covering the period from 1988 to 2009, were evaluated. For the cases diagnosed with some type of disease relevant to the study, clinical data such as the gender, age and ethnicity of the patient, the anatomical site of the disease and its symptomatology were collected. RESULTS: Of all the cases registered at the above-mentioned service, 82 (0.8%) corresponded to immune-mediated skin diseases with symptoms affecting the oral cavity. The diseases found in this study were: oral lichen planus, pemphigus vulgaris and benign mucous membrane pemphigoid. Oral lichen planus was the most common lesion, comprising 68.05% of the cases analyzed. Of these cases, 64.3% were women and the cheek mucosa was the anatomical site most commonly affected (46.8%). CONCLUSION: Immune-mediated skin diseases affecting the oral cavity continue to be rare, the prevalence found in this study being similar to that reported for the majority of regions worldwide. Nevertheless, early diagnosis is indispensable in the treatment of these diseases, bearing in mind that systemic involvement is possible in these patients. Keywords: Lichen planus, oral; Pemphigoid, benign mucous membrane; Pemphigus

Serum Vitamin Profile in Oral Lichen Planus Patients in Southwest of Iran

“…Most of the patients in this study were female (67.6%) which is consistent with many previous studies [2,6,14,27]. This is probably related to the autoimmune base of disease that is more evident in women than men [28][29][30]. It could also be explained by the higher referral rate of women to doctors.…”

“…Vitamin A was evaluated in this study due to its immunomodulatory effect [23,24]. OLP etiology is suggested to be highly relevant to immune system disorders [2,27,28], and therefore, vitamin A deficiency could be also considered a cause of exacerbating OLP manifestations. In the present study, we recorded a lower level of vitamin A in the OLP group but the difference between the two groups was not significant.…”

Descrição de tratamento para pênfigo vulgar: relato de caso

“…Na literatura, o pênfigo não é uma patologia comum, tendo prevalência de 0,5 a 3,2 casos por 100.000 habitantes e a incidência anual é de 0,1 a 0,5 casos por 100.000 habitantes [11][12][13][14][15] . O mesmo é categorizado em pênfigo foliáceo, pênfigo vulgar, pênfigo vegetante, pênfigo eritematoso, pênfigo paraneoplásico (PPN), a pênfigo-IgA e o pênfigo herpetiforme 2,[16][17][18] .…”

“…De acordo com Guillen, Khachemoune 23 , o diagnóstico do pênfigo vulgar se dar pela história clínica e histopatológico, embora já exista outros métodos avançados para isso, os quais não são disponibilizados facilmente pelo o sistema público de saúde. Neste caso clínico, a conduta de biópsia para diagnóstico diferencial das lesões foi baseada no padrão adotado pela literatura, assemelhando-se a outros estudos 2,[24][25][26] . Segundo Arundhathi, Ragunatha, Mahadeva 27 e Xu et al 28 , vale ressaltar que o diagnóstico apenas clínico não é suficiente devido à semelhança do pênfigo vulgar com as demais manifestações dermatológicas mediadas imunologicamente, como penfigóide benigno das membranas mucosas, líquen plano, eritema multiforme, lúpus eritematoso sistêmico e doença do enxerto versus hospedeiro, sendo necessário biopsia e analise histopatológica.…”

“…O pênfigo vulgar é uma doença dermatológica, a qual é ativada pelo o sistema imunológico contra constituintes do próprio organismo. É um tipo de manifestação clínica grave e interfere diretamente na qualidade de vida do sujeito, sendo por isso ainda um alvo de intensa investigação, uma vez que desafia o cirurgião dentista a um diagnóstico precoce e tratamento adequado [1][2] .…”