Mucous membrane pemphigoid: a retrospective study.

BACKGROUND

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.

STUDY DESIGN

The charts of 729 patients in a university-based dental referral practice were reviewed.

RESULTS

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.

CONCLUSIONS

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.