The role of immunofluorescence in the physiopathology and differential diagnosis of recurrent aphthous stomatitis.
Recurrent aphthous stomatitis (RAS) is a disease characterized by the periodic appearance of aphthous lesions on the oral mucosa, of which etiology and physiopathology are not well explained. Recent studies with direct immunofluorescence show controversial results. Some reveal that the basic disorder is associated with humoral immunity, while others point to changes in cellular immunity. Atypical forms of aphthous stomatitis may have its differential diagnosis carried out with vesicobullous diseases, such as pemphigus vulgaris.


OBJECTIVE
Check the presence of immunocomplexes in the mucosa of patients with aphthous stomatitis and the usefulness of the differential diagnosis method with bullous skin diseases.


METHODS
23 patients with aphthous stomatitis were prospectively included in the study. There were all submitted to mucosa biopsy under local anesthesia for the removal of two fragments. One of these was sent to histology and, the other to direct immunofluorescence.


RESULTS
The 23 samples from the histology exam revealed an ulcerated inflammatory process. The samples referred to immunofluorescence resulted negative and only one showed the presence of complement in the basal membrane.


CONCLUSIONS
Based on our results, we conclude that the patients with RAS do not show deposits of immunocomplexes in their oral cavity mucosa and immunofluorescence is useful in the differential diagnosis between this disease and bullous skin diseases.
Wilhelmsen
Niels Salles Willo
NS
University of São Paulo Medical School (HC-FMUSP), Brazil.
Weber
Raimar
R
Miziara
Ivan Dieb
ID
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D004812:Epidemiologic Methods; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000276:immunology; D012008:Recurrence; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis*; D013281:Stomatitis, Aphthous / Q000175:diagnosis* / Q000276:immunology
D007132:Immunoglobulin Isotypes