Abstract
SUMMARY The oral mucosa was examined in fifteen patients with active dermatitis herpetiformis. The lesions seen were classified as erythematous, pseudo-vesicular, purpuric, and erosive in type. The only symptom experienced was of a painful, burning sensation in lesions on the tongue and upper alveolar ridge in two patients. The distribution of lesions, predominantly on the buccal mucosa adjacent to the occlusal plane or beneath existing dentures, suggested that trauma was a factor in their pathogenesis. Histologically, the features noted were similar to those occurring in skin lesions, except that sub-epithelial microvesicle formation was seen in only one of nine biopsies, and that purpura was a predominant feature. Also, the presence of granular IgA deposits in the submucosal papillae of early lesions was similar to the reported skin findings with the direct immunofluorescence technique. Oral lesions were found in over 70% of patients examined; an incidence much higher than previously supposed.
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