Chiou Shirley, Gobetti John P, D'Silva Nisha J
University of Michigan School of Dentistry, USA.
J Mich Dent Assoc. 2007 May;89(5):46-52.
Mucous membrane pemphigoid (MMP) is a vesiculobullous, autoimmune disease that occurs primarily in older women. The objective of this study was to perform a retrospective analysis of the intraoral clinical signs, symptoms and diagnostic findings of MMP.
The charts of 729 patients in a university-based dental referral practice were reviewed.
Of 729 patients, a clinical diagnosis of MMP was rendered in 29 cases. Of these cases, 93 percent had only oral lesions at the time of presentation, whereas 7 percent had lesions at other sites in addition to the oral cavity. Sixty-eight percent were female and 83 percent of the patients were over 50 years at onset. Common sites of involvement were gingiva and buccal mucosa. Sixty-three percent exhibited erosive or ulcerative lesions. Thirty-five percent showed clinical evidence of epithelial separation. Eighty-eight percent of biopsied patients had histopathologic findings consistent with MMP. Seventy-seven percent of patients exhibited IgG and C3 in the basement membrane region, consistent with pemphigoid. Eighty-two percent of the 29 patients who had two or more lesions were treated with topical corticosteroids.
The intraoral sites most commonly affected by MMP are the gingiva and buccal mucosa. Routine histopathologic evaluation is an effective diagnostic tool when used in conjunction with direct immunofluorescence.
黏膜类天疱疮（MMP）是一种水疱大疱性自身免疫性疾病，主要发生于老年女性。本研究的目的是对MMP的口腔内临床体征、症状及诊断结果进行回顾性分析。
回顾了一所大学牙科转诊诊所729例患者的病历。
729例患者中，29例临床诊断为MMP。其中，93%的患者初诊时仅有口腔病变，7%的患者除口腔病变外其他部位也有病变。68%为女性，83%的患者发病年龄超过50岁。常见受累部位为牙龈和颊黏膜。63%表现为糜烂或溃疡性病变。35%有上皮分离的临床证据。88%的活检患者组织病理学结果与MMP相符。77%的患者在基底膜区域出现IgG和C3，符合类天疱疮表现。29例有两处或更多处病变的患者中，82%接受了局部皮质类固醇治疗。
MMP最常累及的口腔部位是牙龈和颊黏膜。常规组织病理学评估与直接免疫荧光检查联合使用时是一种有效的诊断工具。
