Chronic Pemphigus Vulgaris of the Gingiva: A Case Report With a 6‐Year Follow‐up

Abstract

Since the initial lesions of pemphigus vulgaris often appear in the oral cavity, dentists have a major role in the recognition and diagnosis of this condition. The patient reported here was seen with a mild gingival form of the disease and has been managed successfully for the past 6 years without systemic steroids and with minimal topical steroid therapy. For most of that period he was managed without medication. Various aspects of the disease, including diagnosis, the significance of pemphigus antibodies and therapy are reviewed to provide a better perspective on this case.

A novel explanation for acantholysis in pemphigus vulgaris: The basal cell shrinkage hypothesis

“…The involvement of these pathways in the pathogenesis of acantholysis may explain why the current immunosuppressive agents used to treat pemphigus, all of which have complex effects on cellular functions, 40 can improve the disease while high circulating levels of pemphigus antibodies are still present, 41,42 and why topical therapy that has no effect on antibody levels can be effective. [43][44][45] CONCLUSIONS The hypothesis we propose and the ones currently accepted are not mutually exclusive. It may be that each contributes partially to the final pathology of PV.…”

Number II Pemphigus vulgaris

“…Gingival lesions are less common and at the onset, may frequently appear as isolated blisters and/or erosions mainly located on free gingivae, very little in extension and hard to recognize as bullous lesions (Mignogna et al , 2001). Advanced manifestations usually comprise severe desquamative or erosive gingivitis, where bullae have ruptured to leave flaps of peeling tissue with red erosions or deep ulcerative craters mainly on the attached gingivae (Shklar et al , 1978; Markitziu and Pisanty, 1983; Orlowski et al , 1983; Barnett, 1988).…”

Pemphigus vulgaris presenting as gingival involvement

“…[11] Gingival lesions are less common and usually comprise severe desquamative or erosive gingivitis, characterized by red erosions or deep ulcerative craters. [12]…”