Clinical characterization of pemphigoid with oral lesions: A case series

Abstract

The pemphigoid family of bullous pemphigoid (BP) and mucous membrane pemphigoid (MMP) are autoimmune disorders that are characterized by subepidermal blistering and the development of oral lesions. We herein describe the clinical and pathological features of 11 cases of pemphigoid encountered in our department. Eight cases were diagnosed with BP and three with MMP. One case of BP was diagnosed as dipeptidyl peptidase-4 inhibitor-induced BP. Oral lesions were located in the gingiva in seven cases, the buccal mucosa in five, the lip in two, and the soft palate and tongue in one in the first visit. Seven cases of BP (7/8) had skin lesions, and one case of MMP (1/3) had a mucous lesion in the conjunctiva in the first visit. Oral lesions were detected at an average of 2.8 sites. Enzyme-linked immunosorbent assays showed that 8 (8/11) cases were positive for the anti-BP180-NC16a antibody. All cases with oral lesions received oral care, a topical treatment with dexamethasone valerate, and mouth rinse with sodium gualenate hydrate. This study might suggest that pemphigus could be suspected, diagnosed, and treated through oral lesions.