Oral management of pemphigus vulgaris in the intensive care unit

Prá, Ketelin Juliane Dal; Tristão, Stefanny da Silva Santucci de Assis; Matias, Diogo Toledo; Carrillo, Camila Merida; Peres, Maria Paula Siqueira De Melo; Ribas, Priscila Fernandes

doi:10.1111/scd.12454

Cited by 7 publications

(13 citation statements)

References 25 publications

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“…In 11 studies (84.6%), the laser was applied singly and in 2 studies (15.4%), it was used concurrently with steroid therapy (Table 1 ). Five articles reported the effect of the laser directly on the gingival tissues [ 14 , 30 , 38 , 41 , 48 ]. Three studies [ 14 , 30 , 38 ] showed that all gingival cases were successfully treated with PBM, while two studies [ 41 , 48 ] reported unsatisfactory response to the laser for some patients.…”

Section: Resultsmentioning

confidence: 99%

“…Another autoimmune disease with an important oral manifestation is PV, comprising a group of rare autoimmune bullous diseases that affect the skin and mucous membranes [ 13 ]. Oral lesions usually precede skin lesions or are the only manifestation of the disease, affecting areas such as the lips, gingiva, oral mucosa, and palate [ 14 ]. Oral manifestations of PV can be very painful, disrupting oral intake and, consequently, affecting patients’ quality of life on a negative manner [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, alternative treatment modalities have emerged. Among them, photobiomodulation (PBM), also called low-level laser therapy (LLLT), or laser therapy, stands out [ 14 , 28 , 29 ]. Different types of laser (ultraviolet, helium–neon, and diode) with distinct doses, output power, and time of irradiation are applied to the injury site and the irradiation is repeated for several sessions [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

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Photobiomodulation of gingival lesions resulting from autoimmune diseases: systematic review and meta-analysis

et al. 2022

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Objectives To evaluate the effects of photobiomodulation (PBM) in gingival lesions resulting from autoimmune diseases; to compare PBM and topical corticosteroid (CS) treatment; and to assess PBM outcome over time of follow-up. Materials and methods A comprehensive electronic search was performed in four electronic databases. Treatment effects were measured through visual analog scale of pain (VAS) and clinical evolution of lesion (Thongprasom scale for oral lichen planus (OLP)). Meta-analysis was performed to compare PBM with topical corticosteroid treatment and to evaluate PBM effect over time of follow-up. Results Seventeen studies were included in this review, of which six were used for the meta-analysis. Meta-analysis results showed no significant differences between PBM and topical CS in pain reduction at baseline (MD = 0.20, 95% CI = − 0.92, 1.32, p = 0.72) and 60-day follow-up (MD = 0.63, 95% CI = − 3.93, 5.19, p = 0.79); however, VAS showed significant pain reduction when compared before and after PBM at 30-day (MD = − 3.52, 95% CI = − 5.40, − 1.64, p = 0.0002) and 60-day (MD = − 5.04, 95% CI = − 5.86, − 4.22, p < 0.00001) follow-up. Thongprasom clinical scale for OLP also showed significant improvement at 30-day follow-up (MD = − 2.50, 95% CI = − 2.92, − 2.08, p < 0.00001) after PBM. Conclusion PBM led to significant reduction of pain and clinical scores of the lesions, not having shown significant differences when compared to topical CS. Clinical relevance PBM has been used in the treatment of autoimmune gingival lesions, but so far there is little strong evidence to support its use.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Photobiomodulation of gingival lesions resulting from autoimmune diseases: systematic review and meta-analysis

et al. 2022

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“…Diagnosis of the PV is based on identification of clinical manifestations and confirmation by incisional biopsy of the affected perilesional tissue of the skin or mucous membranes [ 13 ]. Clinically, oral lesions are the first manifestations of the disease in 50-90% of the patients with widespread blisters affecting the oral mucosa, most commonly in areas subjected to frictional trauma [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Oral and Umbilical Locations as a First Sign of Pemphigus Vulgaris

Moussaoui

Oueslati

Oualha

et al. 2021

Case Reports in Dentistry

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The place of pemphigus vulgaris (PV) among autoimmune bullous diseases (AIBD) is well established. It is an acquired chronic, autoimmune, vesiculobullous disease in which IgG antibodies target desmosomal proteins to produce intraepithelial mucocutaneous blistering. The diagnosis is often challenging for the clinicians. It requires a combination of three major features: clinical, histopathological, and immunological. Clinically, oral lesions are the first manifestations of the disease in 50-90% of the patients with widespread blisters affecting the oral mucosa. On the skin, lesions are characterized by flaccid blisters that rapidly progress into erosions and crust formation. Umbilical lesions as a clinical manifestation of PV are peculiar and have rarely been reported, and they are not yet completely elucidated. Umbilical region involvement in patients with pemphigus was assessed in a limited study totalling just 10 patients. This localisation may be a valuable hint easing the diagnosis at the clinical level for patients with oral mucosal blisters. Dentists must be familiar with the clinical manifestations of PV to make an early diagnosis and start an early treatment which determines the prognosis of the disease. To the best of the authors’ knowledge, the coexistence of these lesions with the oral lesions as a first sign of PV in the absence of skin involvement was reported in only one case of pemphigus vegetans (PVe). In this paper, we describe an observation of a female patient that was diagnosed with PV that begun with simultaneous oral and umbilical locations which coexisted for a period of 4 months before the appearance of other cutaneous lesions. We highlight the role of dentists, by being familiar with the clinical manifestations of PV, to make an early diagnosis to start an early treatment which determines the prognosis of the disease and to follow closely the evolution of lesions to change treatment if required. We also discuss the clinical, histological, and immunological features of the disease that enabled the differential diagnosis as well as the appropriate therapeutic management.

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“…In oral lesions, topical corticosteroids can be applied along with systemic treatments; however, the concomitant use of biomodulation through low-level laser therapy has been recently shown to regulate pain and promote analgesia, in addition to the significant healing benefit. 21 azathioprine are effective options. 27 Recently, some alternative therapies such as medicinal herbs and ozone therapy have been proposed.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Oral Lesions in Dermatological Diseases: A Retrospective Study

Teixeira‐Souza

Pessôa

Ramos

et al. 2020

Rev. Bras. Odontol.

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Objetivo: Este estudo teve como objetivo estabelecer a prevalência das lesões orais nas doenças dermatológicas. Material e Métodos: A população do estudo consistiu de 119 pacientes com dermatoses (conforme prontuário). Os dados demográficos e clínicos coletados incluem sexo, cor da pele, idade do diagnóstico e localização anatômica de lesão. Resultados: Prevalência significativa do sexo feminino (n = 74; 63%; p = 0,01) e cor de pele branca (n=7; 65%; p<0,001). A idade do diagnóstico variou de 10 a 86 anos, com alta prevalência de indivíduos >20 anos (n= 6; 73%; p=0,05). A lesão mais frequente foi o pênfigo vulgar (38%), seguido de líquen plano oral (30%); Penfigóide (17%); Lúpus Eritematoso (10%); Eritema multiforme e Epidermólise bolhosa (3%); Estomatite Ulcerativa Crônica e Pioestomatite vegetante (1%). Conclusão: As doenças dermatológicas podem afetar a mucosa oral, causando impacto significativo na qualidade de vida dos pacientes, o que compreendeu principalmente a população jovem em nosso estudo. O pênfigo vulgar foi a doença mais prevalente. O monitoramento contínuo por uma equipe multidisciplinar é essencial, uma vez que esse grupo de doenças não tem cura e/ou prognóstico variável.

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Oral management of pemphigus vulgaris in the intensive care unit

Cited by 7 publications

References 25 publications

Photobiomodulation of gingival lesions resulting from autoimmune diseases: systematic review and meta-analysis

Photobiomodulation of gingival lesions resulting from autoimmune diseases: systematic review and meta-analysis

Simultaneous Oral and Umbilical Locations as a First Sign of Pemphigus Vulgaris

Prevalence of Oral Lesions in Dermatological Diseases: A Retrospective Study

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