Pemphigus vulgaris: a case-based update.
Pemphigus vulgaris (PV) is an autoimmune disease accounting for 80% of all cases of pemphigus. Before the advent of corticosteroid therapy, pemphigus was fatal, with a mortality rate of up to 75% in the first year. It is still a serious disorder, but the 5% to 10% mortality rate is now primarily due to the side effects of therapy. In 75% to 80% of cases, PV lesions first appear in the oral cavity. Dentists are therefore in a unique position to recognize the oral manifestations of the disease, allowing early diagnosis and initiation of treatment. The diagnosis is based on pathological examination and immunofluorescence testing. Systemic corticosteriods and steroid-sparing agents are the mainstays of treatment; topical corticosteroids may also be used to accelerate healing of persistent oral lesions. This article describes a 71-year-old woman with multiple chronic ulcers in the oral cavity, in whom PV was diagnosed 4 months after the symptoms first appeared. The article also reviews the current literature on diagnosis and treatment of the condition.
Ben Lagha
Nadia
N
Faculty of Oral Surgery, Department of Odontology, Hôpital Charles Foix, Ivry-sur-Seine, France. nadiabenlagha@yahoo.fr
Poulesquen
Vincent
V
Roujeau
Jean-Claude
JC
Alantar
Alp
A
Maman
Louis
L
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001507:Beclomethasone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D009059:Mouth Diseases / Q000188:drug therapy / Q000473:pathology*; D009061:Mouth Mucosa / Q000473:pathology*; D010392:Pemphigus / Q000188:drug therapy / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D001507:Beclomethasone; D011241:Prednisone; D008727:Methotrexate