Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.
Pain perception is affected by a wide range of contributing factors, including biological, psychological, and social factors. Although the provision of visual information could have a modulatory effect on pain perception, it is unclear whether such a visual effect might vary depending on the anatomical site and stimulation type. This study aimed to analyze the modulatory effect of visual information on the perception of sharp and dull pain in the face and hand and to assess the influence of individual fear levels on modulatory visual information.Methods: Methods: A total of 68 healthy male and female volunteers were recruited for this study. Pressure and pricking pain with and without visual information were induced on the masseter and thenar muscles, and alterations in pain threshold were evaluated. The survey was conducted using the Geop-Pain Questionnaire (GPQ). Results: Results:The pricking pain threshold of the hand was significantly elevated when viewing the stimulated hand. This result indicated that the provision of visual information could decrease sensitivity to sharp pain in the hand. However, when correlating the GPQ score with the alteration in thresholds induced by visual information, no significant correlation was observed between the GPQ score and the threshold difference induced by visual information. This finding showed that the visual effect was not significantly affected by the fear level.Conclusions: Conclusions: This study showed that the effect of visual information on the pain threshold could vary according to the anatomical site and stimulation type. A better understanding of such a modulatory effect on pain perception might be useful for clinicians during painful therapeutic procedures.
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