• Journal of Oral Medicine and Pain
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• 제26권2호
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• pp.121-126
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• 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
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• 제46권2호
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• pp.63-68
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• 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
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• 제40권4호
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• pp.135-139
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• 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.

• 대한치과의사협회지
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• 제52권12호
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• pp.726-733
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• 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.

• 대한치과의사협회지
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• 제52권2호
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• pp.96-104
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• 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
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• 제35권4호
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• pp.259-264
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• 2010

만성 궤양성 치은 병소는 편평태선, 양성점막유천포창, 심상성 천포창 등과 같은 다양한 질환에 의해 유발될 수 있으며 코티코스테로이드 약물요법이 주된 치료로 이용된다. 코티코스테로이드를 복용하는 경우 위장장애, 체중증가 등의 부작뿐만 아니라 장기 복용 시 골다공증, 당뇨 및 고혈압 발생 또는 악화, 부신기능 저하, 쿠싱증후군 등의 심각한 부작용이 발생 할 수 있어 병소가 국소 부위에 제한되어 발생하거나 전신증상을 동반하지 않는 경우 스테로이드 약물의 국소 도포가 만성 궤양성 치은 병소의 주된 치료로 이용되고 있다. 하지만 국소 스테로이드 치료를 구강 내에 사용하는 경우 타액 분비, 혀, 입술, 협점막 등의 움직임에 의해 도포한 약제가 소실되어 효과가 감소되고 병소가 넓은 부위에 분포하거나 구강 내 깊숙한 부위에 발생하는 경우 환자 스스로 약물을 도포하기가 용이하지 않으며, 질병에 이환 되지 않은 정상 점막에도 약제가 도포 되는 등의 단점이 있다. 국소 스테로이드 적용 방법의 단점을 극복하고 효과를 최대화함으로써 스테로이드 복용을 최소화할 수 있는 방법으로 스텐트를 이용한 스테로이드 밀폐 요법이 보고된 바 있으나 실제 임상에서 적극적으로 활용되지는 않고 있다. 따라서 만성 궤양성 치은 병소가 발생한 환자에게 스텐트를 이용한 국소스테로이드 치료를 시행하여 양호한 치료 효과를 보인 증례를 통해 그 효용성과 임상적 활용 방안을 알아보고자 한다.