Arpita Rai, Monica Arora, Venkatesh Naikmasur, Atul Sattur, Varun Malhotra
Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.
Santosh Medical College, Ghaziabad, India.
Ethiop J Health Sci. 2015 Oct;25(4):367-72.
Pemphigus is a potentially life threatening autoimmune disease that causes blisters and erosions of the skin and the mucous membrane. The epithelial lesions are a result of auto-antibodies that react with desmosomal glycoproteins that are present on the cell surface of the keratinocyte. The autoimmune reaction against these glycoproteins causes a loss of cell to cell adhesion, resulting in the formation of intraepithelial bullae. Eighty to ninety percent of patients with pemphigus vulgaris develop oral lesions and in 60% of cases oral lesions are the first sign. Timely recognition and therapy of oral lesion is critical as it may prevent skin involvement. If treatment is instituted during this time, the disease is easier to control and the chance for an early remission of the disorder is enhanced.
This case report describes the case of a patient who complained of ulcers of the mouth and difficulty in swallowing since 20 days, who was diagnosed as having Pemphigus vulgaris. Due to early diagnosis, lower doses of medication for a shorter period of time could control the disease.
Dental professionals must be sufficiently familiar with the clinical manifestations of pemphigus vulgaris to ensure early diagnosis and treatment which in turn determines the prognosis and course of the disease.
天疱疮是一种潜在威胁生命的自身免疫性疾病,可导致皮肤和黏膜出现水疱和糜烂。上皮病变是自身抗体与角质形成细胞表面存在的桥粒糖蛋白发生反应的结果。针对这些糖蛋白的自身免疫反应导致细胞间黏附丧失,从而形成上皮内大疱。80%至90%的寻常型天疱疮患者会出现口腔病变,60%的病例中口腔病变是首发症状。及时识别和治疗口腔病变至关重要,因为这可能预防皮肤受累。如果在此期间开始治疗,疾病更容易控制,疾病早期缓解机会增加。
本病例报告描述了一名患者,自20天前开始出现口腔溃疡和吞咽困难,被诊断为寻常型天疱疮。由于早期诊断,在较短时间内使用较低剂量的药物就能控制疾病。
牙科专业人员必须充分熟悉寻常型天疱疮的临床表现,以确保早期诊断和治疗,这反过来又决定了疾病的预后和病程。