Four cases of mucous membrane pemphigoid with clinical features of oral lichen planus.
BACKGROUND
Mucous membrane pemphigoid (MMP) and oral lichen planus (OLP) show similar clinical features on the oral mucosa. As clinical manifestations of oral mucosal lesions, MMP shows blisters and erosions, whereas OLP shows lace-like whitish lesions in an annular arrangement with erythema and erosions. Histopathologically, MMP shows subepithelial bullae with infiltrates of lymphocytes and neutrophils, whereas OLP shows band-like interface infiltration of lymphocytes with damage in basal cells. However, these two diseases are frequently difficult to distinguish both clinically and histopathologically.


OBJECTIVE
We report four patients with oral MMP who showed OLP-like clinical and histopathological lesions.


METHODS
We performed direct immunofluorescence, indirect immunofluorescence of normal human skin and 1 m NaCl-split skin, enzyme-linked immunosorbent assays for BP180, BP230, and desmogleins 1 and 3, and immunoblotting of normal human epidermal and dermal extracts, recombinant proteins of BP180-NC16a and -C-terminal domains, concentrated culture supernatant of HaCaT cells, and purified laminin-332.


RESULTS
The results of various immunological studies suggested the diagnoses of various types of MMP for all four patients.


CONCLUSIONS
Because MMP and OLP require different treatments, all dentists and dermatologists should have knowledge about the disease entity and the serological diagnostic methods for various types of MMP.
First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan.
Aoi
A
Fukuda
First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan.
Akio
A
Himejima
Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan.|Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan.|Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan.
Daisuke
D
Tsuruta
Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan.|Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan.
Hiroshi
H
Koga
Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan.|Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan.
Bungo
B
Ohyama
First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan.
Shosuke
S
Morita
Department of Dermatology, Kurume University School of Medicine , Fukuoka, Japan.|Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan.
Takashi
T
Hashimoto
D000368:Aged; D001323:Autoantibodies / Q000032:analysis*; D001324:Autoantigens / Q000032:analysis / Q000235:genetics / Q000276:immunology; D015815:Cell Adhesion Molecules / Q000276:immunology; D002460:Cell Line; D051183:Desmoglein 1 / Q000032:analysis / Q000276:immunology; D051184:Desmoglein 3 / Q000032:analysis / Q000276:immunology; D003937:Diagnosis, Differential; D000071821:Dystonin / Q000032:analysis / Q000276:immunology; D005260:Female; D006801:Humans; D017676:Lichen Planus, Oral / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D024041:Non-Fibrillar Collagens / Q000032:analysis / Q000235:genetics / Q000276:immunology; D010390:Pemphigoid, Benign Mucous Membrane / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D011994:Recombinant Proteins / Q000032:analysis; D012867:Skin / Q000737:chemistry; D000097794:Kalinin; D000097805:Collagen Type XVII
D001323:Autoantibodies; D001324:Autoantigens; D015815:Cell Adhesion Molecules; D051183:Desmoglein 1; D051184:Desmoglein 3; D000071821:Dystonin; D024041:Non-Fibrillar Collagens; D011994:Recombinant Proteins; D000097794:Kalinin; D000097805:Collagen Type XVII; C486268:DST protein, human