Pemphigus Vulgaris and its Comprehensive Management: Report of Two Cases and Literature Review

Authors

  • Yadira V. Boza Oreamuno Especialidad y Maestría en Patología y Medicina Oral. Profesora asociada, Sección de Ciencias Diagnósticas, Facultad de Odontología, Universidad de Costa Rica, Costa Rica. Author https://orcid.org/0000-0002-0367-8664
  • Jorge González Quesada Especialidad y Maestría en Periodoncia. Profesor Sección de Periodoncia, Facultad de Odontología, Universidad de Costa Rica, Costa Rica. Author https://orcid.org/0000-0003-0728-8011

DOI:

https://doi.org/10.15517/ijds.2021.46637

Keywords:

Pemphigus; Desquamative gingivitis; Corticosteroids; Biopsy; Oral Hygiene.

Abstract

In the oral cavity, gingiva lesions may occur that are not associated with bacterial plaque, which require adequate diagnosis and treatment. Desquamative gingivitis is usually related to mucocutaneous disorders, such as pemphigus vulgaris (PV), where oral lesions, including gingival lesions, may precede skin lesions. Management is multidisciplinary and treatment includes topical and systemic pharmacological therapy, require adequate control of dental plaque by the patient and strict supervision over time by the professional for the maintenance and stability of the gingival tissues. Two clinical cases of patients with a diagnosis of PV are presented, which were managed in a timely and integral way to control and stabilize the systemic and local factor.

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References

Holmstrup P., Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Clin Periodontol. 2018; 45: S28-43. DOI: https://doi.org/10.1111/jcpe.12938

Maderal A.D., Lee Salisbury P., Jorizzo J.L. Desquamative gingivitis: Diagnosis and treatment. J Am Acad Dermatol [Internet]. 2018; 78 (5): 851-61. Available from: https://doi.org/10.1016/j.jaad.2017.04.1140 DOI: https://doi.org/10.1016/j.jaad.2017.04.1140

Scully C., Porter S.R. The clinical spectrum of desquamative gingivitis. Semin Cutan Med Surg. 1997; 16 (4): 308-13. DOI: https://doi.org/10.1016/S1085-5629(97)80021-1

Scully C., Laskaris G. Mucocutaneous disorders. Periodontol 2000. 1998; 18 (1): 81-94. DOI: https://doi.org/10.1111/j.1600-0757.1998.tb00140.x

Lo Russo L., Fierro G., Guiglia R., Compilato D., Testa N.F., Lo Muzio L., et al. Epidemiology of desquamative gingivitis: Evaluation of 125 patients and review of the literature. Int J Dermatol. 2009; 48 (10): 1049-52. DOI: https://doi.org/10.1111/j.1365-4632.2009.04142.x

Feliciani C., Cozzani E., Marzano A.V., Caproni M., Di Zenzo G., Calzavara-Pinton P. Italian guidelines in pemphigus - adapted from the European Dermatology Forum (EDF) and European Academy of Dermatology and Venerology (EADV). G Ital di Dermatologia e Venereol. 2018; 153 (5): 599-608. DOI: https://doi.org/10.23736/S0392-0488.18.06073-X

McMillan R., Taylor J., Shephard M., Ahmed R., Carrozzo M., Setterfield J., et al. World Workshop on Oral Medicine VI: A systematic review of the treatment of mucocutaneous pemphigus vulgaris. Oral Surg Oral Med Oral Pathol Oral Radiol [Internet]. 2015; 120 (2): 132-142.e61. Available from: http://dx.doi.org/10.1016/j.oooo.2015.01.022 DOI: https://doi.org/10.1016/j.oooo.2015.01.022

Stoopler E.T., Sollecito T.P. Oral mucosal diseases: Evaluation and management. Med Clin North Am [Internet]. 2014; 98 (6): 1323-52. Available from: http://dx.doi.org/10.1016/j.mcna.2014.08.006 DOI: https://doi.org/10.1016/j.mcna.2014.08.006

Shamim T., Varghese V.I., Shameena P.M., Sudha S. Pemphigus vulgaris in oral cavity: Clinical analysis of 71 cases. Med Oral Patol Oral Cir Bucal. 2008; 13 (10): 2-6.

Rath S.K., Reenesh M. Gingival pemphigus vulgaris preceding cutaneous lesion: A rare case report. J Indian Soc Periodontol. 2012;16 (4): 588-91. DOI: https://doi.org/10.4103/0972-124X.106922

Grando S.A., Bystryn J.C., Chernyavsky A.I., Frušić-zlotkin M., Gniadecki R., Lotti R., et al. Apoptolysis: A novel mechanism of skin blistering in pemphigus vulgaris linking the apoptotic pathways to basal cell shrinkage and suprabasal acantholysis. Exp Dermatol. 2009; 18 (9): 764-70. DOI: https://doi.org/10.1111/j.1600-0625.2009.00934.x

Didona D., Maglie R., Eming R., Hertl M. Pemphigus: Current and future therapeutic strategies. Front Immunol. 2019; 10 (June): 1-28. DOI: https://doi.org/10.3389/fimmu.2019.01418

Kasperkiewicz M., Ellebrecht C.T., Takahashi H., Yamagami J., Zillikens D., Payne A.S., et al. Pemphigus. Nat Rev Dis Prim. 2017;3. DOI: https://doi.org/10.1038/nrdp.2017.26

Kneisel A., Hertl M. Blasenbildende Autoimmundermatosen. Teil 1: Klinik. JDDG - J Ger Soc Dermatology. 2011; 9 (10): 844-57. DOI: https://doi.org/10.1111/j.1610-0387.2011.07793.x

Sultan A., Villa A., Saavedra A., Treister N., Woo S. Oral mucous membrane pemphigoid and pemphigus vulgaris-a retrospective two-center cohort study. Oral Dis. 2017; 23 (4): 498-504. DOI: https://doi.org/10.1111/odi.12639

Scully C., Paes De Almeida O., Porter S.R., Gilkes J.J.H. Pemphigus vulgaris: The manifestations and long-term management of 55 patients with oral lesions. Br J Dermatol. 1999; 140 (1): 84-9. DOI: https://doi.org/10.1046/j.1365-2133.1999.02612.x

Nishikawa T., Hashimoto T., Shimizu H., Ebihara T., Amagai M. Pemphigus: From immunofluorescence to molecular biology. J Dermatol Sci. 1996; 12 (1): 1-9. DOI: https://doi.org/10.1016/0923-1811(95)00459-9

Silva S.C., Nasser R., Payne A.S., Stoopler E.T. Pemphigus Vulgaris. J Emerg Med [Internet]. 2019; 56 (1): 102-4. Available from: https://doi.org/10.1016/j.jemermed.2018.10.028 DOI: https://doi.org/10.1016/j.jemermed.2018.10.028

Buonavoglia A., Leone P., Dammacco R., Di Lernia G., Petruzzi M., Bonamonte D., et al. Pemphigus and mucous membrane pemphigoid: An update from diagnosis to therapy. Autoimmun Rev [Internet]. 2019; 18 (4): 349-58. Available from: https://doi.org/10.1016/j.autrev.2019.02.005 DOI: https://doi.org/10.1016/j.autrev.2019.02.005

Harman K.E., Brown D., Exton L.S., Groves R.W., Hampton P.J., Mohd Mustapa M.F., et al. British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017. Br J Dermatol. 2017; 177 (5): 1170-201. DOI: https://doi.org/10.1111/bjd.15930

Cholera M., Chainani-Wu N. Management of Pemphigus Vulgaris. Vol. 33, Advances in Therapy. Springer Healthcare; 2016. 910-958 p. DOI: https://doi.org/10.1007/s12325-016-0343-4

Damoulis P.D., Gagari E. Combined Treatment of Periodontal Disease and Benign Mucous Membrane Pemphigoid. Case Report With 8 Years Maintenance. J Periodontol. 2000; 71 (10): 1620-9. DOI: https://doi.org/10.1902/jop.2000.71.10.1620

Benito-Urdaneta M., Chaparro N., Benito-Urdaneta M, Pérez L, Bernardoni-Socorro C. Tratamiento periodontal en paciente con liquen plano. Presentación de un caso. Cienc Odontológica. 2008; 5 (1): 44-52.

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Published

2026-05-26

Issue

Vol. 24 No. 3 (2022): (September-December) Odovtos-International Journal of Dental Sciences

Section

Literature Review Articles

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