Pemphigus vulgaris and the current concepts for dental practice: case report
DOI:
https://doi.org/10.34019/1982-8047.2020.v46.31513Keywords:
Pemphigus, Oral Manifestations, Autoimmune DiseasesAbstract
Introduction: Pemphigus vulgaris is an autoimmune disease characterized by the formation of bullets in mucous membranes and/or skin that is easily strewn, causing irregular injuries. The prognosis depends on early treatment, reducing risks of secondary infection and/or aggravation of a condition that could lead to death. Objective: To report a clinical case and its conduct with a guided discussion on the current aspects of the literature on the teaching of the dental approach. Case Report: Female patient, 24-years-old, with leukoderma, with pain from the back and gingival desquamation who did not regress after 1 year of therapies focused on the control of biofilms and oral hygiene habits. On an extra-oral exam, no injuries were observed. An intraoral examination was observed in the presence of erythema with small points of shallow and painful ulceration on the vestibular marginal gingiva. The Nikolsky test carried out with an aid of a syringe, resulting in positive. Incisional biopsy was performed in a region near this location. Histopathology showed mucosal lesion due to acanthosis, with the formation of an intraepithelial fissure and Tzank cells, culminating in the diagnosis of Pemphigus Vulgaris. Or treatment consisting of topical corticosteroids, main clobetasol in occlusive therapy, showing adequate control of ulcers and dormancy. Conclusion: Pictures of gingivitis not associated with the biofilm represent a challenge to the dentistry routine, and the vulgar pemphigus must be part of the role of hypotheses for the development of an adequate prophetic procedure, providing quality of life and early diagnosis.
Downloads
References
Cholera M, Chainani-Wu N. Management of pemphigus vulgaris. Adv Ther. 2016; 33(6):910-58.
Nishikawa T, Hashimoto T, Shimizu H, Ebihara T, Amagai M. Pemphigus: from immunofluorescence to molecular biology. Journal of dermatological science. 1996; 12(1):1-9.
Sharma VK, Bhari N, Gupta S, Sahni K, Khanna N, Ramam M et al. Clinical efficacy of rituximab in the treatment of pemphigus: a retrospective study. Indian J Dermatol Venereol Leprol. 2016; 82(4):389-94.
Harman KE, Brown D, Exton LS, Groves RW, Hampton PJ, Mohd Mustapa MF et al. British Association of Dermatologists' guidelines for the management of pemphigus vulgaris 2017. Br J Dermatol. 2017; 177(5):1170-201.
Feliciani C, Cozzani E, Marzano AV, Caproni M, Di Zenzo G, Calzavara-Pinton P et al. Italian Guidelines in Pemphigus: adapted from the European Dermatology Forum (EDF) and European Academy of Dermatology and Venerology (EADV). G Ital Dermatol Venereol. 2018; 153(5):599-608.
Sultan AS, Villa A, Saavedra AP, Treister NS, Woo SB. Oral mucous membrane pemphigoid and pemphigus vulgaris-a retrospective two-center cohort study. Oral Dis. 2017; 23(4):498-504.
Neville WB, Damm DD, Allen CM, Bouquot JE. Patologia oral & maxilofacial. 3. ed. Rio de Janeiro: 2017.
Dietze J, Hohenstein B, Tselmin S, Julius U, Bornstein SR, Beissert S et al. Successful and well-tolerated bi-weekly immunoadsorption regimen in pemphigus vulgaris. Atheroscler Suppl. 2017; 30:271-7.
Ojaimi S, O'Connor K, Lin MW, Schifter M, Fulcher DA. Treatment outcomes in a cohort of patients with mucosal-predominant pemphigus vulgaris. Intern Med J. 2015; 45(3):284-92.
Almeida O. Patologia oral. Serie ABENO São Paulo Artes Médicas. 2016.
Arduino PG, Broccoletti R, Carbone M, Gambino A, Sciannameo V, Conrotto D et al. Long-term evaluation of pemphigus vulgaris: a retrospective consideration of 98 patients treated in an oral medicine unit in north-west Italy. J Oral Pathol Med. 2019; 48(5):406-12.
Maderal AD, Lee Salisbury P, Jorizzo JL. Desquamative gingivitis: diagnosis and treatment. J Am Acad Dermatol. 2018; 78(5):851-61.
Hertl M, Jedlickova H, Karpati S, Marinovic B, Uzun S, Yayli S et al. Pemphigus. S2 Guideline for diagnosis and treatment: guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol. 2015; 29(3):405-14.
Yaghubi E, Daneshpazhooh M, M DJ, Mohammadi H, Sepandar F, Fakhri Z et al. Effects of l-carnitine supplementation on cardiovascular and bone turnover markers in patients with pemphigus vulgaris under corticosteroids treatment: a randomized, double-blind, controlled trial. Dermatol Ther. 2019; 32(5):e13049.
Pereira ALC, Bolzani FCB, Stefani M, Charlín R. Uso sistémico de corticosteróides: revisión de literatura. Medicina Cutánea Ibero-Latino-Americana. 2007; 35(1):35-50.
Downloads
Published
How to Cite
Issue
Section
License
Cessão de Primeira Publicação à HU Revista
Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.