title: Discovery of a patient with strongly suspected bullous pemphigoid in a ward by oral health care providers.
abstract: OBJECTIVE
  Oral health care providers may discover systemic diseases incidentally from signs observed in the oral cavity. Here, we report a case in which oral health care providers in a hospital discovered a patient with strongly suspected bullous pemphigoid (BP), which is a relatively rare but important disease, in a ward.
  
  
  METHODS
  The patient was a 78-year-old Japanese woman admitted to our hospital because of severe Alzheimer's disease. We discovered recurrent ulcers in the oral mucosa and skin when performing oral care in her ward. Biopsy could not be performed safely because of involuntary biting. We performed blood tests for anti-BP180-NC16a antibody, which is autoantibody specific for BP.
  
  
  RESULTS
  The patient had a very high anti-BP180-NC16a antibody titre. We consulted a dermatologist regarding her clinical course and the clinical features of the oral mucosa and skin along with blood test results. BP was very strongly suspected.
  
  
  CONCLUSIONS
  In cases in which oral health care providers suspect their patients may have BP, appropriate examination and provision of information to the doctor are important. Oral health care providers should have knowledge about systemic diseases, the signs of which appear in oral cavity to avoid missing important systemic diseases.
authors.affiliation: Department of Dentistry, Mannari Hospital, Okayama, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kanda
authors.forename: Y
authors.initials: Y
authors.lastname: Soga
authors.forename: M
authors.initials: M
authors.lastname: Meguro
authors.forename: A
authors.initials: A
authors.lastname: Tanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Yagi
authors.forename: Y
authors.initials: Y
authors.lastname: Himuro
authors.forename: Y
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: S
authors.initials: S
authors.lastname: Takashiba
authors.forename: N
authors.initials: N
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications*; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000097:blood / Q000276:immunology; D017742:Dental Care for Chronically Ill; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007297:Inpatients; D024041:Non-Fibrillar Collagens / Q000097:blood / Q000276:immunology; D010391:Pemphigoid, Bullous / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D000097805:Collagen Type XVII
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D024041:Non-Fibrillar Collagens; D000097805:Collagen Type XVII