Pemfigus Vulgaris Manifestasi di Mulut dan Penatalaksanaannya

Abstract

Pemfigus is an autoimmune disease involving the skin and mucosa and characterized by intraepidermal bullae formation. The four variations of pemphigus are pemphigus vulgaris, vegetans, foliaceus, and erythematosus. Although several clinical variants are recognized, pemphigus vulgaris is the most common form and the type most likely to exhibit oral manifestations. There are from 0,1 to 0,5 cases reported each year per 100,000 population with the highest incidence occurring in the fourth and seventh decades of life. Only rare cases have been reported in children and the elderly. Before the advent of systemic corticosteroid therapy, pemphigus vulgaris was fatal within few months to two years. A characteristic feature is the nikolsky sign which is the ability to elicit the formation of bullae by the application of firm lateral pressure on normal-appearing skin. The oral lesions often have a slow, insidious onset with symptoms present for many months before a diagnosis is made or skin lesions develop. Lesions may be found anywhere but are most common on the palate, buccal mucosa, and gingiva. Although the oral lesions are vesicobullous in nature, intact blisters are rarely seen. Diagnosis is established by biopsy and immunofluorescent studies. Titers on indirect immunofluorescence often correlate to the severity of the disease. The aim of this study is to promote and support early dental diagnosis when the prognosis is good.