Tag Archives: pemphigus vulgaris

Oral pemphigus Part 2

Bullae may present on any oral or oropharyngeal surface, but typically arise in the buccal, palatal and gingival regions. Occasional patients have lesions restricted completely to the gingiva. Skin lesions are similar except that the more heavily keratinized epidermis allows blisters to remain intact much longer. Most patients have circulating autoantibodies which can be detected by indirect immunofluorescence using serum from other affected individuals. Titers are directly proportionate to the severity of the disease. Continue reading

Oral pemphigus Part 1

Pemphigus vulgaris is an autoimmune or “self-allergy” disease in which a patient’s own circulating antibodies become altered so that they attack the points of adhesion of the epithelial cells, one to another, of the skin and mucous membranes. Women are more frequently affected than men and the disease is usually diagnosed between the ages of 50-70 years, often with oral blisters as the first sign. Children are rarely affected. The typical lesion is a small or large, clear-fluid blister which breaks rapidly in the mouth to leave a flat white, somewhat tender ulcer with a thin red line around it. Skin blisters may last for hours or days, and blisters may be caused by pressure on the skin or membranes of the mouth. There is no cure, but pemphigus is treated with heavy doses of corticosteroids and azathioprine, with frequent relapses after the therapy is stopped. Secondary infection is common because of the immune system suppression from these drugs. The overall mortality is less than 6%, usually from infection or loss of body fluid from a large number of blisters. Continue reading