Buajeeb Waranun, Pimolbutr Kununya, Panpradit Naruemon, Okuma Nis
Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
J Dent Sci. 2022 Apr;17(2):1009-1017. doi: 10.1016/j.jds.2021.11.007. Epub 2021 Nov 24.
BACKGROUND/PURPOSE: Mucous membrane pemphigoid (MMP) is a rare autoimmune disease affecting mucous membrane of the body. Oral involvement is common causing chronic and painful lesions. This study aimed to characterize oral MMP in a group of Thai patients and to analyze treatment regimens.
The files of patients attending Oral Medicine Clinic were retrospectively studied. Patients fulfilled diagnostic criteria of MMP were included. Chief complaints, medical and dental history, oral manifestations and investigations of individual patients were summarized. Treatment regimens and efficacy were also analyzed.
There were fourteen patients (age range 33-70 years) with a diagnosis of MMP. The prevalence of oral MMP was 0.51%. The lesions presented as vesicles, blood blisters, erosions, ulcers, erythema, either one type or in combination. Common complaints were chronic painful and bleeding gums. Gingival lesions were found in 13 of 14 patients (92.86%). The most common direct immunofluorescence findings were linear C3 at basement membrane zone (92.31%) followed by linear IgG deposition (84.62%). Most lesions were successfully managed with topical and/or systemic corticosteroids. The average time to control disease was 1.97 months (IQR, 0.69-12.73 months).
Gingival lesions are very common in MMP. Mainstay of treatment is combination of systemic and topical corticosteroids. Multidisciplinary care including oral hygiene maintenance is necessary.
背景/目的：黏膜类天疱疮（MMP）是一种罕见的自身免疫性疾病，可累及身体的黏膜。口腔受累很常见，会导致慢性疼痛性病变。本研究旨在描述一组泰国患者的口腔MMP特征并分析治疗方案。
对口腔内科门诊患者的病历进行回顾性研究。纳入符合MMP诊断标准的患者。总结了个体患者的主要诉求、病史和牙科病史、口腔表现及检查情况。还分析了治疗方案和疗效。
有14例患者（年龄范围33 - 70岁）被诊断为MMP。口腔MMP的患病率为0.51%。病变表现为水疱、血疱、糜烂、溃疡、红斑，可为单一类型或多种类型组合。常见主诉为牙龈慢性疼痛和出血。14例患者中有13例（92.86%）发现牙龈病变。最常见的直接免疫荧光结果是基底膜区线状C3沉积（92.31%），其次是线状IgG沉积（84.62%）。大多数病变通过局部和/或全身使用皮质类固醇成功控制。控制疾病的平均时间为1.97个月（四分位间距，0.69 - 12.73个月）。
牙龈病变在MMP中非常常见。治疗的主要方法是全身和局部皮质类固醇联合使用。包括保持口腔卫生在内的多学科护理是必要的。
