Department of Oral Diagnostics, School of Dentistry at Matsudo, Nihon University, Matsudo, Japan.
Department of Periodontics, Texas A&M College of Dentistry, Dallas, TX, USA.
Oral Dis. 2022 Sep;28(6):1555-1560. doi: 10.1111/odi.13872. Epub 2021 Apr 18.
The objective of this study was to evaluate the frequency of upper aerodigestive tract involvement in patients with mucous membrane pemphigoid associated with desquamative gingivitis.
Data from 25 patients were collected by retrospective chart review. Their upper aerodigestive had been evaluated using a conventional flexible fiberscope. Oral disease activity was quantified on the basis of the Mucous Membrane Pemphigoid Disease Area Index activity score.
Lesions of the upper aerodigestive tract were confirmed in nine symptomatic patients (9/25, 36%), of which five (5/25, 20%) had laryngeal involvement. No lesions were seen in the asymptomatic patients on fiberscope examination. There was a statistically significant difference in the symptoms, high oral disease activity score, and linear IgA deposition on direct immunofluorescence between patients with and without upper aerodigestive tract lesions (p = .001, .001, .002, respectively).
The high frequency of considerable complications highlights the importance of confirming the presence of upper aerodigestive tract involvement in patients with mucous membrane pemphigoid having desquamative gingivitis. Signs including the presence of symptoms, high oral disease activity score, or linear IgA deposition on direct immunofluorescence might indicate a higher risk of upper aerodigestive tract involvement.
本研究旨在评估伴有脱屑性龈炎的黏膜类天疱疮患者上呼吸道受累的频率。
通过回顾性病历审查收集了 25 名患者的数据。使用常规纤维喉镜对上呼吸道进行评估。根据黏膜类天疱疮疾病面积指数活动评分来量化口腔疾病活动度。
在 9 名有症状的患者（9/25，36%）中确认了上呼吸道病变，其中 5 名（5/25，20%）有喉部受累。在纤维喉镜检查中，无症状患者未见病变。有上呼吸道病变的患者与无症状患者在症状、高口腔疾病活动评分和直接免疫荧光线性 IgA 沉积方面存在统计学差异（p=.001，p=.001，p=.002）。
较高的严重并发症发生率强调了在伴有脱屑性龈炎的黏膜类天疱疮患者中确认上呼吸道受累的重要性。存在症状、高口腔疾病活动评分或直接免疫荧光线性 IgA 沉积等迹象可能表明上呼吸道受累的风险更高。
