title: Oral lichen planus pemphigoides: a series of four cases.
abstract: OBJECTIVE
  Lichen planus pemphigoides (LPP), which is a rare autoimmune blistering mucocutaneous disease of the pemphigoid family of diseases, is characterized by the development of vesiculobullous lesions on or adjacent to the areas of lichen planus (LP). LPP primarily affects the skin, and oral involvement alone is rare. The objective of this case series was to report four new cases of oral LPP.
  
  
  METHODS
  We present four cases with clinical, histologic, and direct immunofluorescence (DIF) features characteristic of LPP, with three cases having oral involvement only.
  
  
  RESULTS
  The four patients (including two males) were aged 49, 50, 51, and 61 years; only one patient had skin lesions. All patients had typical reticular, erythematous, or ulcerative oral LP involving the gingiva and the buccal mucosa. Mucosal biopsies showed features consistent with LP, mucous membrane pemphigoid (MMP), or a combination of both, and DIF studies in all 4 cases showed linear deposition of immunoglobulin G (IgG) and C3 at the interface.
  
  
  CONCLUSIONS
  Correlation of clinical findings, routine histopathology, and DIF studies is essential for the diagnosis.
authors.affiliation: Oral Medicine Resident, Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA; Oral Medicine Resident, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA. Electronic address: Ahmed_sultan@hsdm.harvard.edu.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sultan
authors.affiliation: Oral and Maxillofacial Pathology Resident, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
authors.forename: Ivan James
authors.initials: IJ
authors.lastname: Stojanov
authors.affiliation: Clinical Associate Professor of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA; Center for Oral Pathology, StrataDx, Lexington, MA, USA.
authors.forename: Mark Adam
authors.initials: MA
authors.lastname: Lerman
authors.affiliation: Center for Oral Pathology, StrataDx, Lexington, MA, USA.
authors.forename: Sadru
authors.initials: S
authors.lastname: Kabani
authors.affiliation: Periodontist, Private practice, Wellesley, MA, USA.
authors.forename: Jerome
authors.initials: J
authors.lastname: Haber
authors.affiliation: Periodontist, Private practice, Concord, MA, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Freedman
authors.affiliation: Center for Oral Pathology, StrataDx, Lexington, MA, USA; Associate Professor of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA; Chief of Clinical Affairs, Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Sook-Bin
authors.initials: SB
authors.lastname: Woo
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017676:Lichen Planus, Oral / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000175:diagnosis* / Q000188:drug therapy