Oral mucous membrane pemphigoid and pemphigus vulgaris—a retrospective two‐center cohort study

• Published in: Oral diseases Vol. 23; no. 4; pp. 498 - 504
• Main Authors: Sultan, AS, Villa, A, Saavedra, AP, Treister, NS, Woo, S‐B
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.05.2017
• Subjects: Administration, Oral; Administration, Topical; Adrenal Cortex Hormones - therapeutic use; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents - therapeutic use; desquamative gingivitis; Diagnosis, Differential; Female; Follow-Up Studies; gingival involvement; Humans; Male; Middle Aged; Mouth Diseases - diagnosis; Mouth Diseases - drug therapy; Mouth Diseases - pathology; Mouth Mucosa - pathology; oral manifestations; oral mucous membrane pemphigoid; oral pemphigus vulgaris; Pemphigoid, Benign Mucous Membrane - diagnosis; Pemphigoid, Benign Mucous Membrane - drug therapy; Pemphigoid, Benign Mucous Membrane - pathology; Pemphigus - diagnosis; Pemphigus - drug therapy; Pemphigus - pathology; Retrospective Studies; Treatment Outcome; desquamative gingivitis; oral pemphigus vulgaris; gingival involvement; oral mucous membrane pemphigoid; oral manifestations
• ISSN: 1354-523X; 1601-0825; 1601-0825
• DOI: 10.1111/odi.12639

Objectives Few studies have compared oral mucous membrane pemphigoid (MMP) and pemphigus vulgaris (PV). Descriptive analysis of oral features, extent of extra‐oral involvement, and management outcomes were performed. Subjects and Methods Patients with PV and MMP, the latter with exclusive oral involvement at first presentation, were included. Results There were 26 MMP (46%) and 31 PV (54%) patients. Desquamative gingivitis was evident in 84% of MMP cases compared to 28% of PV cases (P < 0.05). Non‐gingival lesions were noted in 6% of MMP cases compared to 55% of PV cases (P < 0.01). Management of MMP consisted of only topical corticosteroids in 88% of cases while 12% of cases required concomitant systemic therapy. All PV cases (100%) required systemic therapy. No patients with MMP developed scarring or ocular lesions, and one patient (4%) developed cutaneous lesions. Five PV cases (16%) had oral cavity involvement only with three (60%) developing pharyngeal involvement and two (40%) developing cutaneous lesions on follow‐up. Conclusion Oral MMP presents primarily as desquamative gingivitis, infrequently involving extragingival sites, and is highly amenable to topical therapy, while PV is a systemic mucocutaneous disease with extensive non‐gingival oral lesions that almost always requires systemic therapy.