Oral mucosal lesions in patients with pemphigus and pemphigoid skin diseases: a cross sectional study from southern India.

Authors

  • Arvind Babu Rajendra Santosh Dentistry Programme, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica, West Indies.
  • Venkat Ramana Reddy Baddam Department of Oral and Maxillofacial Pathology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India.
  • Chigurupati Anuradha Department of Oral and Maxillofacial Pathology, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, India.
  • Chandrashekar Poosarla Department of Oral and Maxillofacial Pathology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India

DOI:

https://doi.org/10.5195/d3000.2017.59

Keywords:

Pemphigus, pemphigoid, autoimmune, epidemiology, oral disease.

Abstract

Objective:To assess the prevalence of oral mucosal lesions in patients with pemphigus and pemphigoid diseases from Southern India. Design and Methods: A cross-sectional hospital based study was conducted from August 2010 to July 2011. Patients with confirmed pemphigus and pemphigoid skin disease were selected and informed to participate in the study. Oral examination of all participants were done to document site and type of oral manifestation and diagnostic procedures such as histopathological and Immunofluorescence methods were performed to confirm the diagnosis. Demographic details such as age, gender and occupation were also documented. The results of the study were analyzed by SPSS software version 19.0 (Armonk, NY) and presented as descriptive statistics. Results: Sixty percent of the patients exhibited oral mucosal manifestations. A higher female (86.66%) predilection of autoimmune blistering disease was observed in the study. A slightly higher number of pemphigoid patients (53.33%, 16 out of 30) were reported than pemphigus (46.66%, 14 out of 30 cases). The most common subtypes of pemphigus is Pemphigus vulgaris 71% (10 out of 14) among pemphigus, and bullous pemphigoid 87.5%(14 out of 16) among pemphigoid. Buccal mucosa (92.85%) is the most common site in pemphigus patients, where as hard palate (12.5%) is mostly commonly reported site in pemphigoid patients. Initial involvement of oral tissue in disease process was observed in 78.57% of pemphigus, and 12.5% of pemphigoid patients. Conclusion: Oral mucosal lesions are more frequently associated in pemphigus patients. Oral mucosal lesions are the initial site of disease process in pemphigus patients. The significance of diagnosis of oral lesions at earlier stage of disease, specifically pemphigus may help in early intervention of disease and help to reduce the morbidity and mortality state. The study emphasizes multidisciplinary approach in diagnosis and management of both pemphigus and pemphigoid.

References

Budimir J1, Mihić LL, Situm M, Bulat V, Persić S, Tomljanović-Veselski M. Oral lesions in patients with pemphigus vulgaris and bullous pemphigoid. Acta Clin Croat. 2008;47(1):13-8.

Bascones-Martinez A, Munoz-Corcuera M, Bascones-Ilundain C, Esparza-Gómez G (2010) Oral Manifestations of Pemphigus Vulgaris: Clinical Presentation, Differential Diagnosis and Management. J Clin Exp Dermatol Res 1:112.

Nada M Suliman, Anne N Åstrøm, Raouf W Ali, Hussein Salman and Anne C Johannessen.Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan. BMC Oral health 2013;13:66

Petruzzi M. Mucous membrane pemphigoid affecting the oral cavity: short review on etiopathogenesis, diagnosis and treatment. Immunopharmacol Immunotoxicol. 2012;34(3):363-7.

Arvind Babu RS, P Chandrasekar, K Lalith Prakash Chandra, G Sridhar Reddy, K Krian Kumar, BV Ramana Reddy. Immunofluorescence and its application in dermatopathology with oral manifestations: Revisited. J Oro Fac Sci 2013;5(1):2-8.

Xiang Ding, Luis A Diaz, Janet A Fairley, George J Giudice, Zhi Liu. The anti-desmoglein 1 autoantibodies in Pemphigus vulgaris sera are pathogenic. Journal of Invest Dermatol 1999;112:739-43.

Velia A Ramrez Amador, Lilly Esquirvel Pedraza, Rocio Orozco Topete. Frequency of oral conditions in dermatology clinic. International journal of Dermatology 2000;39:501-5

Libu GK, Thomas Bina, Lucy Raphael, SHyam E Balakrishnan, Biju George, Joan Felicita Samson. Prevalence and socio-demographic determinants of skin disease among lower primary school children in Calcicut, Kerala. Kerala Medical Journal 2009;5:185-90.

Kidangazhiyathmana Ajith Kumar. Incidence of pemphigus in Thrissur district, South India. Indian J Dermatol Veneerol Leprol 2008;74(4):349-51.

Langan SM, Smeeth L, Hubbard R, Flemming KM, Smith CHP, West J. Bullous pemphigoid and pemphigus vulgaris – incidence and mortality in the UK population based cohort study. British Medical Journal 2008;337(180):1-7.

Thorakkal Shamim, Vengal Ipe Varghese, Pallikandi Maliyekkal Shameena, Sivasankar Sudha. Pemphigus vulgaris in oral cavity: Clinical analysis of 71 cases. Med Oral Pathol Oral Cir Buccal 2008;13(10):622-6.

Anuradha CH, Anandan, Magesh KT, Malathi N. Current concepts of Immunofluorescence in Oral mucocutaneous disease. Journal of Oral and Maxillofacial Pathology 2011;15(3):261-66.

Fadia Ata Ali, Javier Ata Ali. Pemphigus vulgaris and mucous membrane pemphigoid: update on etiopathogenesis, oral manifestations and management. J Clin Exp Dent 2011;3(3): 246-50.

Sunil Dogra, Amrinder Jit Kanwar. Mucous membrane pemphigoid. Indian J Dermatol 2003;48(4):239-40.

Stephen J Challacombe, Jane Setter field, Pepe Shirlaw, Karen Harman, Crispian scully, Martin M Black. Immunodiagnosis of pemphigus and Mucous membrane pemphigoid. Acta odontol scand 2001;59(4):226-34.

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Published

2017-03-28

Issue

Vol 5, No 1 (2017)

Section

Adults & the Elderly

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