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Pemphigus Vulgaris (PV) is an autoimmune intraepithelial blistering disease involving the skin and mucous membranes. Oral mucosa is frequently affected in patients with PV, and oral lesions may be the first sign of the disease in majority of patients. In some patients, oral lesions may also be followed by skin involvement. Therefore, timely recogni...
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Most of the mucocutaneous diseases are confined to the stratified squamous epithelium and thus may involve skin, oral and other mucosae like the nasal, ocular, genital mucosa. Some patients present with oral lesions only whereas in others there may be involvement of skin and other mucous membranes. An understanding of the basic molecular aspects of...
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... The criteria for the diagnosis of pemphigus are the presence of appropriate clinical lesion, histopathological picture of acantholysis in biopsy specimens, and identification of autoantibodies in the tissue or serum, or both [22]. ...
Introduction: Pemphigus is an autoimmune blistering mucocutaneous disease. Production of auto-antibodies against desmosomal glycoproteins is a characteristic feature of the disease. Oral lesions of pemphigus vulgaris are many a times first sign of the disease and hence it is important for a dentist to be familiar with the clinical appearance, diagnosis, and treatment modalities. Case Report: This report describes a case of pemphigus vulgaris in a female patient who presented with ulcers on the gingiva. On the basis of clinical examination and histopathology, we arrived at a diagnosis of pemphigus vulgaris, which was confirmed by immunofluorescence. Conclusion: If left undiagnosed or untreated pemphigus vulgaris may be fatal. Early diagnosis will aid in appropriate treatment and better outcome of the disease.
... The gingiva is the least frequently affected site, and desquamative gingivitis (DG) is a common symptom of the disease. The buccal mucosa is the most frequently affected site, followed by the palatal, lingual, and labial mucosae [5]. In many PV patients, the development of skin lesions comes after the development of oral lesions [3]. ...
... Because of this, if oral PV is discovered early on, treatment can start to stop the disease from developing into skin involvement [3]. However, early oral lesions of PV are frequently thought to be difficult to diagnose because they can initially present as superficial erosions or ulcerations and infrequently form intact bullae [5]. ...
... Adjuvant drugs used are Azathioprine, Cyclosporine, Cyclophosphamide, Myco-phenolate mofetil, Methotrexate [7], Tetracycline and Dapsone [6,8]. The choice of drugs to be given depends on the severity of the disease and the clinicians' judgement [5,6]. Histopathology with Immune-fluorescent study is the gold standard for diagnosis of pemphigus [1,9]. ...
Pemphigus Vulgaris (PV) is an intraepithelial blistering disease that frequently affects the skin and mucous membranes. The oral mucosa is frequently affected in pemphigus patients. It does not have any gender preferences and can affect both men and women aged 40 to 60. In many patients, oral lesions may be the only initial indication of the disease. Oral lesions may be followed by skin lesions in some patients. PV manifests as blisters and erosions of the skin and the mucous membrane. Timely diagnosis and treatment of oral lesions is important. It is a challenge to diagnose PV with oral lesions because of their nonspecific presentations. The lesions are superficial erosions or ulcerations. Intact bullae are difficult to find but when found may be filled with clear liquid. Lesions may occur anywhere on the oral mucosa including gingiva. Gum inflammation or desquamative gingivitis is less common compared to other muco-cutaneous conditions such as mucous membrane pemphigoid (MMP) or oral lichen planus. This paper describes a case of a patient presenting with a three years history of painful and burning sensation of gingiva, which was earlier misdiagnosed and treated as gingivitis. Finally, it was diagnosed as a case of pemphigus vulgaris.
... The oral mucous membrane is frequently affected in PV patients; most of the patients present with oral lesions as the first sign of PV (Pettini et al., 2015). Lesions may occur anywhere on the oral mucosa, but the buccal mucosa is the most commonly affected site, followed by involvement of the palatal, lingual, and labial mucosae; the gingiva is the least commonly affected site, and desquamative gingivitis (DG) is a common manifestation of the disease (Ohta et al., 2011). In many PV patients, the oral lesions are followed by the development of skin lesions (Rai et al., 2015). ...
... Consequently, if oral PV can be recognized in its early stages, treatment may be initiated to prevent progression of the disease to skin involvement (Rai et al., 2015). Early oral lesions of PV are, however, often regarded as difficult to diagnose, since the initial oral lesions may be relatively nonspecific, manifesting as superficial erosions or ulcerations and rarely presenting with the formation of intact bullae (Ohta et al., 2011). ...
This article presents results from a pilot study conducted with a survey on online reading and writing that was responded by 37 people, and had the objectives of determining how they define digital reading and writing, the time they invest in such activities, how they contribute to everyday life decision-making and it they prefer to communicate online or in person. Among the results, we found that reading was over two hours (27%), two hours (27.1%), one hour (24.3%) and less than an hour (21.6%); 65% dedicated more time to reading, 16.1% to writing and 18.9% to talking with other users. Reading and writing needs were motivated by the purposes of being informed (45.9%), doing homework (24.4%), own decision (18.9%) and leisure (10.8%). What they mostly read inline included scientific articles (29.7%), news (21.6%), books (16.3%), other users’ stories (16.2%), memes (5.4%), recommendations from their acquaintances (2.7%) and others (8.1%). Online reading and writing bring forth opportunities to learn, communicate with others, share their own creations and to write ethically and creatively. We propose that this type of research has gained a renewed importance because of the COVID-19 pandemic, as it is important to update research on online information habits and behaviors.
... [1][2][3][4][5] It is represented by a group of potentially life-threatening autoimmune mucocutaneous diseases such as epithelial blistering affecting the mucosal/cutaneous surfaces. [1][2][3][4][5][6][7][8][9][10] It not only affects the oral mucosa and the skin but also affects the mucosa of the conjunctivae, nose, pharynx, larynx, genitals, and esophagus. [1][2][3] Pemphigus affects 0.1-0.5/100,000 ...
... individuals per year. [1][2][3][4][5][6][7] It affects both sexes equally and is more common in middle-aged and elderly patients, [1,2,4,[6][7][8] but few shows to be slightly predominant in women. [2,6,7] The etiology of pemphigus vulgaris (PV) is not known, and in some cases, it may have a strong genetic basis. ...
... [2] The oral mucous membrane is frequently affected in PV patients; most of patients present with oral lesions as the first sign of PV. Lesions may occur anywhere on the oral mucosa, [3,6,8] but the buccal mucosa [6][7][8] is the most commonly affected site, followed by involvement of the palatal, lingual, and labial mucosae; [6][7][8] the gingiva is the least This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. ...
Pemphigus vulgaris (PV) is an autoimmune mucocutaneous disease characterized by epithelial blistering affecting the mucosal/cutaneous surfaces. This case report demonstrates the oral manifestations of PV in the uncommon locations such as the attached, marginal, and interdental gingiva with no involvement of oral mucosa, tongue, palate, or buccal mucosa.
... The function of desmoglein 1 is preserved preventing the development of skin lesions. Loss of cell to cell adhesion results in the development of intraepithelial blisters that rupture following minimal trauma, sloughing eroded areas of skin [3,5]. ...
... Isso demonstra o quão importante são os conhecidos do profissional sobre a doença pois assim o quanto antes for diagnosticado melhor será a resposta ao tratamento proposto. [14,15] O acompanhamento do presente caso nos primeiros seis meses evidenciou a importância do diagnóstico precoce, a importância do cirurgião-dentista na avaliação de todos os aspectos bucais e o tratamento integrado. ...
Pemphigus vulgaris (PV) is an autoimmune disease that affects skin and mucosa, characterized by the abnormal production of antibodies against glycoproteins that compose the adhesion structures, thus causing acantholytic and the emergence of bubbles. In general, they affect adults in the age range between 40 and 60 years, not presenting prevalence by gender, patients usually complain of pain in the buccal mucosa, and in the clinical examination shows superficial and irregular erosions and ulcers. Despite several studies, there is still a large percentage of cases with late diagnosis, because of this, it is necessary the dentist to be alert to the first signs that often arise in the mouth cavity, to know diagnose and guide the Patient about the disease and its treatment that carried out through drug therapy.
... Tzanck test also Tzanck smear, is scraping of an ulcer base to look for Tzanck cells. According to Coscia-Porrazzi et al., acantholytic/Tzanck cells were recognized in 37 out of 40 PV patients and stated that cytomorphologic studies are useful to screen the cases suspected to be oral PV [11] . Tzanck test offers the advantage of being a simple, fast, and inexpensive diagnostic test but it requires certain amount of skill and experience for accurate interpretation [4] . ...
... Individuals with autoimmune diseases tend to develop autoimmune comorbidities. In cohort studies, PV has been associated with systemic lupus erythematosus, rheumatoid arthritis, autoimmune thyroiditis, type 1 diabetes, and myasthenia gravis [11] . It is also important to assess the mental health of PV patients, since higher rates of depression were observed in all age groups, including children, as well as Parkinson's disease [12] . ...
... Gingiva is less commonly affected by lesions of pemphigus, and in rare instances, it may be the only site affected. [8][9][10] Lesions of gingiva appear as extensive erythema and erosions. [8] Such lesions have been termed desquamative gingivitis, although use the term is not generally recommended since it is descriptive and nonspecific in nature. ...
... [11] Dagistan et al., López-Jornet and Bermejo-Fenoll, Javali and Zainab, Ohta et al., Kumar et al., and several others have shown in the past that oral lesions precede skin lesions frequently. [7][8][9][10]12] However, early identification of the disease seems to be difficult, as oral lesions might be mistaken for less severe and more common lesions of the oral cavity, such as aphthous ulcers, traumatic ulcers, and oral candidiasis. Ohta et al. observed that 1 year had elapsed from the onset of oral lesions to the definitive diagnosis of pemphigus, in their case. ...
... Ohta et al. observed that 1 year had elapsed from the onset of oral lesions to the definitive diagnosis of pemphigus, in their case. [10] The same holds true in our case, wherein the patient had initially been treated symptomatically for oral ulcers and then given antifungal treatment when the lesions did not subside. Three months following his initial oral complaints, he was finally referred to us. ...
Pemphigus is an autoimmune disease affecting the skin and mucosae. Oral lesions are common and sometimes are the only manifestations of the disease. The clinical presentations of pemphigus might mimic other vesiculobullous lesions of the oral cavity. We report a case of a 60-year-old male patient who complained of erosive lesions in the oral cavity. The lesions were diagnosed as pemphigus based on histopathological examination and immunofluorescence findings. The patient did not respond to topical steroids and low doses of systemic steroids. Since the patient began developing dermatological manifestations, he was administered pulse steroid therapy. He is currently under observation and his clinical signs and symptoms show improvement, although he has developed hyperglycemia as a complication.
... Isso demonstra o quão importante são os conhecidos do profissional sobre a doença pois assim o quanto antes for diagnosticado melhor será a resposta ao tratamento proposto. [14,15] O acompanhamento do presente caso nos primeiros seis meses evidenciou a importância do diagnóstico precoce, a importância do cirurgião-dentista na avaliação de todos os aspectos bucais e o tratamento integrado. ...
... Pemphigus Vulgaris (PV) is an autoimmune disorder of the skin and mucous membrane associated with intraepithelial blistering (1,2). It is a chronic disease that affects both the genders. ...
... Gingiva is rarely affected and when involved manifests as desquamative gingivitis (DG) (4). In most patients with PV, the oral lesions are followed by involvement of the skin (1,4). However, in few cases, the oral cavity may be the only site of involvement for nearly a year (4). ...
... The gingiva is the rarest affected site within the oral cavity. A literature search in pubmed revealed only three case reports in the past 20 years with gingival involvement as the first site of manifestation of pemphigus (1,5,6). ...
Pemphigus vulgaris (PV) is a chronic autoimmune disease which may be potentially life threatening. PV manifests as blisters and erosions of the skin and the mucous membrane. It can manifest initially as oral lesions. It is essential to diagnose this condition early in order to avoid the serious complications. We describe a case of 58-year-old male presented with bleeding gums and burning sensation for 6 months. Patient was previously misdiagnosed as gingivitis. Though it is rare for pemphigus vulgaris to present with gingival involvement as primary site of manifestation, our case emphasizes the importance of thorough history and clinical examination for the early diagnosis and management of such condition.
