Management of oral pemphigus vulgaris: A case report and a clinical update

Pettini, Francesco; Ballini, Andrea; Capodiferro, Saverio; Cantore, Stefania; Cirulli, Nunzio; Garofalo, Anna R.; Mf, Coscia; Vito, Danila De; Foti, Caterina

doi:10.1177/1721727x15576854

Cited by 3 publications

(4 citation statements)

References 17 publications

(32 reference statements)

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“…5 The common site for oral mucosal lesions are gingiva, buccal mucosa, lips, and soft and hard palate. 8 In the present case erosive and ulcerative lesions were present on the buccal mucosa, retromolar area, lateral border of tongue, floor of mouth and soft palate. The ulceration and erosion preceded by vesicle formation.…”

Section: Discussionsupporting

confidence: 48%

Oral Pemphigus Vulgaris: A case report

Baral¹,

Ojha²,

Bajracharya³

2020

JCMC

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Pemphigus vulgaris is an autoimmune blistering disease clinically presenting as vesicles, bullae and erosion on the skin and mucous membrane. Histopathologically, it is characterized by acantholysis and supra basilar split. The underlying mechanism causing intra epithelial split in pemphigus vulgaris is binding of IgG autoantibodies to desmoglin 3 which belongs to a transmembrane glycoprotein adhesion molecule. Here we present a case of 27 years old male patient suffering from pemphigus vulgaris. This Case report highlights the importance of detailed case history, thorough clinical examination and appropriate investigation to reach a diagnosis of vesiculobullous lesion.

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Section: Discussionsupporting

confidence: 48%

Oral Pemphigus Vulgaris: A case report

Baral¹,

Ojha²,

Bajracharya³

2020

JCMC

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“…Pemphigus is a group of chronic autoimmune diseases caused by autoantibodies targeting specific desmosomal proteins on the surface of epithelial cells (in pemphigus vulgaris are typically linked to desmoglein-3 and rarely, in 50% of cases, also to desmoglein-1, the latter an exclusive target antigen in pemphigus foliaceus) with subsequent acantholysis and often with intraepithelial blistering [ 57 , 58 ]. Manifestations in the oral cavity are usually severe and frequently represent the first clinical sign of disease, usually appearing as painful and flaccid vesicles mostly of the gingiva, tongue, and palate with rapid evolution into erosion and ulceration, with the classic positivity to the Nikolsky sign ( Figure 6 ) [ 59 , 60 , 61 , 62 ], Histological examination with adjunctive direct immunofluorescence of the tissues is mandatory for the differential diagnosis, along with blood test including BP180 e BP230. A clinical variant defined as Paraneoplastic pemphigus is often associated to a frequently not yet diagnosed neoplasm (mostly NHL, leukemia, multiple myeloma, etc.…”

Section: Autoimmune and Disimmune Diseasesmentioning

confidence: 99%

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

2021

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Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.

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“…Furthermore, intraoral examination should be included as a routine practice in dermatological services. 1 Treatment of oral lesions of PV include topical or intralesional corticosteroids or immunosuppressant drugs. Specific therapies for the underlying disease are available with local immunosuppressive treatment, but systemic immunosuppressive therapy, notably corticosteroids, is almost inevitably required in pemphigus.…”

Section: Discussionmentioning

confidence: 99%

“…1 Pemphigus vulgaris in most patients manifest with oral lesions initially. They are most commonly seen on the oral mucosa, but the buccal mucosa is affected first, followed by the palatal, lingual, and labial mucosae.…”

Section: Introductionmentioning

confidence: 99%

Pemphigus Vulgaris: Diagnosis with Oral Lesions

Singh¹,

Soni²,

Pereira³

et al. 2017

IJOCRWEB

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A 50-year-old patient reported to the dental college with the complaint of a blister and pain in the lower right back region since 2 months. The patient noticed slight bleeding and a blister associated with the lower right second molar on the gingiva 1 year back. He had visited a dentist where periodontal treatment, scaling and root planing were done. Initially, the bleeding subsided and the blister reduced in size but recurred after 6 to 7 months.Intraoral examination revealed localized erosions involving marginal and attached gingiva of the mandibular right first and second molar. Nikolsky's sign was positive, and the epithelium could be easily peeled away ( Fig. 1). Skin lesions were not present. Differential diagnosis of mucous membrane pemphigoid, erosive lichen planus, and PV was arrived at. A gingival biopsy was performed from the perilesional site of the involved gingiva and sent for histopathological examination.Histopathological examination showed acantholysis in the suprabasal region with a "suprabasillar split" (Fig. 2). Intraepithelial vesicle showed Tzanck cells. Connective tissue stroma was loose collagenous with dense inflammatory cells, confirming PV. Patient was asked to undergo Dsg 1 and Dsg 3 tests.Anti-Dsg 1 antibodies were 31.2 U/mL. Anti-Dsg 3 antibodies were 117.4 U/mL. ABSTRACTPemphigus vulgaris (PV) consists of a group of autoimmune blistering diseases of the skin and mucous membrane. The blisters occur in the epithelium where the patient's immunoglobulin G (IgG) autoantibodies are produced in response to triggering factors that target two structured proteins of desmosomes identified as desmogleins (Dsg) 1 and 3. It is essential that dentists should know these pathologies in order to be able to diagnose them at an early stage of the disease and to direct patients for adequate treatment. This article presents a case report along with its treatment plan.

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Management of oral pemphigus vulgaris: A case report and a clinical update

Cited by 3 publications

References 17 publications

Oral Pemphigus Vulgaris: A case report

Oral Pemphigus Vulgaris: A case report

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

Pemphigus Vulgaris: Diagnosis with Oral Lesions

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