CLINICOPATHOLOGIC FEATURES OF ORAL CAVITY VESICULOBULLOUS DISEASES SEEN IN THE UF ORAL MEDICINE AND DERMATOLOGY CLINICS

Abstract

<h3>Introduction</h3> Vesiculobullous disorders encompass several rare conditions with varying pathology and morbidity, but similar signs and symptoms. <h3>Materials and Methods</h3> With IRB approval, the record systems of the UF Oral Medicine and UF Dermatology Clinics were searched for cases diagnosed between 2011 and 2020 of the following disorders: pemphigus vulgaris (PV), mucous membrane pemphigoid (MMP), bullous pemphigoid (BP), linear IgA disease, lichen planus pemphigoides, paraneoplastic pemphigus, epidermolysis bullosa acquisita, and angina bullosa hemorrhagica. Exclusion criteria included lack of oral involvement or lack of clinical information and outcome data. Location of lesions within the oral cavity, clinical signs and symptoms, treatment provided, and outcome of treatment were recorded. <h3>Results</h3> A total of 38 cases were included in the study consisting of 20 (52.6%) cases of MMP, 9 (23.7%) cases of PV, 6 (15.8%) cases of BP, and 3 (7.9%) cases of EBA. Twenty-two patients were male (57.9%) and 16 were female (42.1%). Age range was 34 to 92 years, with a mean of 69.7 years. EBA was seen in patients with the highest average age (74.7 years) while patients with PV were the youngest on average (59.8 years). About 90% of MMP cases affected the gingiva, while only one case (16.7%) of BP involved the gingiva. Pain was the most common feature associated with both types of pemphigoid. Ulcerations and erosions were the most common features seen in PV and EBA. All (100%) of EBA cases, 88.9% of PV cases, 66.7% of BP cases, and 25.0% of MMP cases required treatment beyond topical steroids. These therapies included topical tacrolimus, prednisone, methotrexate, rituximab, mycophenolate, and dapsone. PV exhibited the highest percentage (22.2%) of cases refractory to treatment. <h3>Conclusion</h3> Most MMP cases were effectively managed with topical steroids. EBV, PV, and BP may require more potent therapy.