• Journal of Oral Medicine and Pain
• /
• v.26 no.2
• /
• pp.121-126
• /
• 2001

Mucous membrane pemphigoid is uncommom disease in oral cavity and synonymous with cicatricial pemphigoid. This disease is caused by autoimmune reaction that autoantibody reacts antigen located in basement membrane and epithelium is separated from underlying connective tissue. It affects female over sixth decade, commonly. Oral mucosa, especially gingiva is common site but conjunctival, nasal, pharyngeal, laryngeal, esophageal, varginal mucosa and skin are involved. Intraoral findings show Nikolsky sign, irregular erythema, erosion, vesicle, and ulceration at mucous membrane. To differentiate from diseases of positive Nikolsky sign, should perform histologic, immunologic test. Histologic features show subbasilar cleft and direct immunologic features show IgG, C3 deposits at basement membrane in linear pattern. Mucous membrane pemphigoid is incurable disease because symptoms are repetitively improved or worsed for several years. Patiens are commonly managed with topical and systemic steroid. To avoid side effects of prolonged steroid therapy and to maintain immunosupressive effects, combination therapy of azathioprine with steroid is effective. This case reports that mucous membrane pemphigoid is diagnosed based on clinical and histologic features, is treated with topical, systemic steroid and azathioprine therapy.

• Journal of Oral Medicine and Pain
• /
• v.46 no.2
• /
• pp.63-68
• /
• 2021

Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

• Journal of Oral Medicine and Pain
• /
• v.40 no.4
• /
• pp.135-139
• /
• 2015

Desquamative gingivitis (DG) is a gingival manifestation of systemic mucocutaneous disorders such as mucous membrane pemphigoid, oral lichen planus, and pemphigus vulgaris. The lesion is very painful, so affects the patient's ability to do proper oral hygiene practices. This may be a potential risk factor for long-term periodontal health. However, there is some controversy about the relationship between the existence of DG and periodontal status. Although the correlation between DG-associated diseases and periodontal status is not to be certain, early diagnosis and appropriate treatment including adequate plaque control and removal of local factors is very important for preventing the progression of diseases and destruction of periodontal tissues.

• The Journal of the Korean dental association
• /
• v.52 no.12
• /
• pp.726-733
• /
• 2014

The gingiva consists of an epithelial layer and an underlying connective tissue layer. The oral epithelium is a keratinized, stratified, squamous epithelium. The epithelium can be divided into the following cell layer: basal layer, prickle cell layer, granular cell layer and keratinized cell layer. The desquamative disease of gingiva means exfoliative diseases of epithelial layer on the gingiva. The chronic desqumative gingivitis is usually related to the dematologic disorders that produce cutaneous and mucous membrane blisters. The cicatricial pemphigoid and lichen planus are representative diseases of the dermatologic cases. Patients may be asymptomatic or symptomatic. When symptomatic, their complaints range from a mild burning sentation to an severe pain. The clinical examination must be considered with a thorough history, and routine histologic and immunofluorescence studies. A systemic approach needs to achieve accurate diagnosis and treatment of the gingival desquamative diseases.

• The Journal of the Korean dental association
• /
• v.52 no.2
• /
• pp.96-104
• /
• 2014

The aim of this study was to investigate the frequency of positive patch test reaction to dental materials in patients with oral mucosal diseases. Epicutaneous patch test was performed in 110 patients with oral mucosal diseases; 41 patients with oral lichen planus(OLP), 44 patients with burning mouth syndrome(BMS), 25 patients with other oral mucosal diseases including recurrent aphthous ulcer and mucous membrane pemphigoid. The obtained results were as follows: Oral gold restorations were most common in patents with oral mucosal diseases and porcelain fused metal crown, implant appeared in the order. 33 of 110 patients did not appear skin reactions (negative, 30%) and 77 patients (positive, 70%) had skin reactions including redness, rash, blisters. Dental materials causing positive reaction to patch test were mainly as gold-sodium-thiosulfate (26.7%), nickel sulfate(Ni) (22.7%), cobalt chloride(Co) (14.7%), palladium chloride(Pd) (11.9%), potassium dichromate (10.7%) in order, respectively. In conclusion, old metal restorations could be the cause of oral mucosal diseases and epicutaneous patch test could be used as a tool to improve the oral conditions.

• Journal of Oral Medicine and Pain
• /
• v.35 no.4
• /
• pp.259-264
• /
• 2010

The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.