Prevalence of oral mucosal lesions in patients with pemphigus vulgaris: A systematic review and meta‐analysis

Abstract

Objective To assess the prevalence of oral mucosal lesions in patients with Pemphigus Vulgaris. Methods Observational studies reporting the prevalence of oral lesions in pemphigus vulgaris patients, without restriction to language and year of publication, were selected in a two‐phase process. Search strategies were applied to PubMed, Scopus, Livivo, Web of Science, LILACS, Google Scholar, and OpenGrey databases. Articles assessing the prevalence of oral lesions in patients with conditions other than pemphigus vulgaris were excluded. Risk of bias analysis was performed using the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data. Synthesis of results was calculated by the software R Statistics version 4.0.2 (The R Foundation). Confidence in cumulative evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results From 1957 studies identified, 40 were included in qualitative synthesis and 38 in meta‐analyses. The pooled prevalence of patients with oral lesions solely or concurrent with other mucocutaneous lesions was 90.3%. The prevalence of patients with exclusive oral mucosal lesions was 50.8%. Risk of bias was considered low, and the certainty of evidence was very low. Conclusion Oral lesions were present in approximately nine out of 10 patients with pemphigus vulgaris. The oral mucosa was the most common site of disease onset. Further longitudinal studies are urged to assess the prevalence of oral lesions at different disease stages.

Pemphigus vulgaris presenting with epigastric pain

“…There are two clinical forms of pemphigus vulgaris: mucosal (MPV) and mucocutaneous (MCPV) which patients' mucosa is affected and over five skin lesions are present 2 . The recent study showed that patients with pemphigus vulgaris have oral lesion about 90% with solely oral mucosal lesion around 50% 3 . The presentation symptoms include tenderness in the throat, pain on swallowing, hoarseness, or dysphonia 2 .…”

Oral Pemphigus Vulgaris Treatment with Corticosteroids and Azathioprine: A Long-Term Study in Shiraz, Iran

“…The first site of involvement in two-thirds of PV patients is the oral mucosa [ 6 , 7 ]. Nevertheless, in most cases in which cutaneous lesions develop first, oral lesions will ultimately arise [ 6 , 8 ].…”

“…The first site of involvement in two-thirds of PV patients is the oral mucosa [ 6 , 7 ]. Nevertheless, in most cases in which cutaneous lesions develop first, oral lesions will ultimately arise [ 6 , 8 ]. The mortality rate of PV has decreased in recent years due to therapeutic advances [ 9 ], but it is still an important cause of significant mortality [ 5 ].…”

“…Therefore, PV treatment has been a challenge during the past decades and continues to be so [ 10 ]. Moreover, the treatment of oral PV is mostly recalcitrant and challenging due to the chronic nature of the disease and the rough oral environment [ 6 ]. Recurrences are common due to the lack of patient cooperation and poor oral hygiene.…”

“…Recurrences are common due to the lack of patient cooperation and poor oral hygiene. Also, the use of dental prostheses and dental restorations, oral habits, smoking, and alcohol consumption can complicate the management [ 6 , 11 , 12 ].…”