scholarly journals PÊNFIGO VULGAR A IMPORTÂNCIA DO CONHECIMENTO DO CIRURGIÃO DENTISTA PARA UM CORRETO DIAGNÓSTICO

Author(s):  
Deyvid Silva Rebouças ◽  
Lucas Souza Cerqueira ◽  
Tila Fortuna Costa ◽  
Thaise Gomes Ferreira ◽  
Roberta Catapano Naves ◽  
...  

Pemphigus is the general name for a group of rare autoimmune diseases that affect the skin and mucous membranes and is presented with the formation of intraepidermal blisters. Pemphigus vulgaris (PV) is a chronic rare vesicular-bullous autoimmune disease that when not diagnosed and treated in its early stages has severe prognosis. This study aims to report a clinical case of a female patient, 32 years of age who had manifestation of pemphigus vulgaris. The oral manifestations are, in most cases, the first signs of the disease and the dentist has a primary role in the early diagnosis.

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Matteo Saccucci ◽  
Gabriele Di Carlo ◽  
Maurizio Bossù ◽  
Francesca Giovarruscio ◽  
Alessandro Salucci ◽  
...  

Oral signs are frequently the first manifestation of autoimmune diseases. For this reason, dentists play an important role in the detection of emerging autoimmune pathologies. Indeed, an early diagnosis can play a decisive role in improving the quality of treatment strategies as well as quality of life. This can be obtained thanks to specific knowledge of oral manifestations of autoimmune diseases. This review is aimed at describing oral presentations, diagnosis, and treatment strategies for systemic lupus erythematosus, Sjögren syndrome, pemphigus vulgaris, mucous membrane pemphigoid, and Behcet disease.


2018 ◽  
Vol 2 (2) ◽  
pp. 117-124
Author(s):  
Indra Gunawan ◽  
Riani Setiadhi

Background : Pemphigus Vulgaris (PV) is an autoimmune intraepithelial blistering disease involving the skin and mucous membranes. Oral lesions could be the first sign of the disease followed by the involvement of skin and other mucosa sites.Objectives : This is oral manifestations of pemphigus vulgaris case report, intended to help clinicians to recognize and treat the oral lesions.Case Reported : Male 27 yo admitted to RSUP Dr.Hasan Sadikin hospital with multiple blisters on the skin and oral mucosa, was diagnosed with Pemphigus Vulgaris.Case Management : Patient was treated with steroid mouth wash and oral paste. After two months of treatment, the patient was fully recovered from oral lesion.Discussion : In PV, autoantibodies are produced against desmosomes spesifically desmoglein 3 which responsible for holding the cells of the epithelium together. The loss of adhesive function due to anti Dsg 3 antibodies result in bulla formation on the oral mucosa.The aetiology for PV is still uncertain. Conclusion :Early recognition and treatment of oral lesions is important as it may prevent skin involvement. Early treatment, patient’s compliance and multi disciplinal teamwork ensure the treatment succes for this disease


2021 ◽  
pp. 1-2
Author(s):  
Tatiana Betancur Pérez ◽  
◽  
Juan Farak Gomez ◽  

The concurrence of COVID-19 with dengue present a similarity in the early stages of both diseases could cause delays in the diagnosis of dengue infection,SARS-CoV-2 or both. This adds an additional difficulty to the diagnosis and suggests that a positive result of IgM or IgG serology would not be sufficient for the definitive confirmation of dengue. Clinical case: 13-year-old female patient in poor general condition who debuts with a clinical picture of 5 days of evolution consisting of fever, anosmia, ageusia, unquantified fever peaks, chills, abdominal pain and vomiting that does not stop.


2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Bassel Tarakji

Pemphigus vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes. The first clinical manifestation is often the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin. The etiological factors of this disease still remain unknown, although the presence of autoantibodies is consistent with an autoimmune disease. A 73-year-old man had bullous lesions on gingiva, oral mucosa first, then scalp, trunk, and face. An oral medicine specialist suspects the lesion in differential diagnosis in the first presentation of oral lesions and follows up the patient, and then these bullous lesions presented on the skin. In this article, a patient had received oral prednisolone (80 mg/kg/day) and azathioprine, then tapered oral prednisolone to 40 mg/day, with a reduction of 5 mg/day every three weeks. The patient shows remission of these lesions, and complication of this treatment includes osteoporosis, hyperglycemia, and hypertension.


2020 ◽  
Vol 96 (6) ◽  
pp. 42-47
Author(s):  
Anna L. Evseeva ◽  
Vera V. Ryabova ◽  
Sergei V. Koshkin ◽  
Olga S. Kovrova

The article presents clinical cases of syphilitic infection from our own practice, which were not recognized by doctors of related specialties at the early stages of the development of the disease. In the first observation, the manifestations of syphilis were regarded as a surgical pathology in the patient, which entailed surgical intervention, which was not necessary as such. The following clinical case demonstrates lesions of the mucous membranes in syphilis, mistakenly recognized by the therapist as streptococcal angina. The atypical hard chancre in the final observation disorientated the surgeon, that led to a delay in the correct diagnosis and, accordingly, in the appointment of adequate treatment. Regardless of the specialty, everyone should not forget about the variety of manifestations of syphilis in all periods. The lack of alertness among doctors of related specialties contributed to the delayed diagnosis and the appointment of specific anti-syphilitic therapy.


MEDISAINS ◽  
2021 ◽  
Vol 19 (2) ◽  
pp. 56
Author(s):  
Widi Rahmaningsih ◽  
Agus Santosa

Background: Pemphigus Vulgaris is an autoimmune disease attacking the skin and mucous membranes. This disease is considered a rare disease. Epidemiological data for Pemphigus Vulgaris in Indonesia remains limited, correspondingly, nursing management in this disease. This study aims to describe nursing management in patients with Pemphigus Vulgaris.Case presentation: a case of Pemphigus Vulgaris in a 28-year-old male was reported, with complaints of blisters all over his body appearing since 2019 and have not been completely recovered at the Banyumas General Hospital, Central Java, Indonesia.Conclusion: A combination of wound care, nutrition, vitamins, and pharmacology can accelerate the recovery of patients with Pemphigus Vulgaris


2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Author(s):  
Jenny L. Pierce

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.


2020 ◽  
Vol 16 ◽  
Author(s):  
Mariam Ahmed Saad ◽  
Mostafa Alfishawy ◽  
Mahmoud Nassar ◽  
Mahmoud Mohamed ◽  
Ignatius N Esene ◽  
...  

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations. Methods: We searched PubMed database using all available keyword for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstract. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected. Results: Among 10006 articles, searches yielded, Thirty-two relevant articles for full-text assessment. Twenty studies meet the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain–Barré syndrome (48.5%). Conclusions: COVID-19 has been implicated in the development in a range of autoimmune diseases which may shed a light on the association between autoimmune diseases and infections.


2020 ◽  
Author(s):  
Xiaoyu He ◽  
Juan Su ◽  
Guangyu Wang ◽  
Kang Zhang ◽  
Navarini Alexander ◽  
...  

BACKGROUND Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are two rare but severe inflammatory dermatoses. Due to the regional lack of trained dermatologists, many patients with these two diseases are misdiagnosed and therefore incorrectly treated. An artificial intelligence diagnosis framework would be highly adaptable for the early diagnosis of these two diseases. OBJECTIVE Design and evaluate an artificial intelligence diagnosis framework for PV and BP. METHODS The work was conducted on a dermatological dataset consisting of 17,735 clinical images and 346 patient metadata of bullous dermatoses. A two-stage diagnosis framework was designed, where the first stage trained a clinical image classification model to classify bullous dermatoses from five common skin diseases and normal skin and the second stage developed a multimodal classification model of clinical images and patient metadata to further differentiate PV and BP. RESULTS The clinical image classification model and the multimodal classification model achieved an area under the receiver operating characteristic curve (AUROC) of 0.998 and 0.942, respectively. On the independent test set of 20 PV and 20 BP cases, our multimodal classification model (sensitivity: 0.85, specificity: 0.95) performed better than the average of 27 junior dermatologists (sensitivity: 0.68, specificity: 0.78) and comparable to the average of 69 senior dermatologists (sensitivity: 0.80, specificity: 0.87). CONCLUSIONS Our diagnosis framework based on clinical images and patient metadata achieved expert-level identification of PV and BP, and is potential to be an effective tool for dermatologists in remote areas in the early diagnosis of these two diseases.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1321.1-1321
Author(s):  
S. Nagpal ◽  
S. Cole ◽  
A. Floudas ◽  
M. Wechalekar ◽  
Q. Song ◽  
...  

Background:Immune checkpoint blockade with agents targeting CTLA4 and PD-1/PD-L1 alone or in combination has demonstrated exceptional efficacy in multiple cancer types by “unleashing” the cytotoxic action of quiescent, tumor-infiltrating T cells. However, the therapeutic action of these immunotherapies goes hand in hand with the loss of immune tolerance and appearance of immune-related adverse events such as colitis, arthralgia and inflammatory arthritis in responsive patients. Therefore, immune checkpoint molecules have been proposed as targets for the treatment of autoimmune diseases.Objectives:Herein, we interrogate the potential of BTLA/HVEM axis as a target for restoring immune homeostasis in rheumatoid arthritis (RA), Systemic Lupus Erythematosus (SLE) and Sjogren’s Syndrome (SjS) by examining their expression patterns in autoimmune disease tissues.Methods:Message and protein expression of BTLA and HVEM were examined in RA and SLE synovial tissues, SLE cutaneous lesions, SjS salivary glands and peripheral blood samples of autoimmune disease by RNA sequencing and flow cytometry.Results:Tissue dysregulation of the BTLA-HVEM axis was observed: Increased BTLA RNA level in RA synovium, SLE-affected skin, and SjS salivary gland samples, whereas HVEM level was affected only in the RA synovium when compared to unaffected tissues. Detailed immunophenotyping of B, T, and myeloid cell populations in RA, SLE, SjS and healthy control PBMCs revealed differential modulation of the BTLA+ or HVEM+ immune cell subsets in a disease-context dependent manner. SjS patients showed an overall decrease in memory B cells and most of the BTLA+ B cell subsets while a decrease in HVEM+ B cells was observed only in SLE PBMC samples and not RA and SLE samples. Immunophenotyping with a T cell panel exhibited decreased BTLA and HVEM expression on T cell subsets in SjS and SLE but not in RA patients. In addition, protein levels of HVEM were differentially decreased in SLE myeloid cell subsets. Finally, we demonstrate tissue-specific surface expression patterns of BTLA in RA and SLE samples: higher surface BTLA levels on RA and SLE PBMC B cells than matched tissue-derived B cells.Conclusion:Our results demonstrate a dysregulation of the BTLA/HVEM axis in either lesional tissue or peripheral blood in an autoimmune disease context-dependent manner. These results also indicate the potential of targeting BTLA-HVEM axis for the treatment of multiple autoimmune diseases.Disclosure of Interests:Sunil Nagpal Shareholder of: Janssen Pharmaceuticals, Employee of: Janssen Pharmaceuticals, Suzanne Cole Shareholder of: Janssen Research & Development employee, Employee of: Janssen Research & Development employee, Achilleas Floudas: None declared, Mihir Wechalekar Grant/research support from: Grant from Janssen Research & Development, Qingxuan Song Shareholder of: Employee of Janssen Research, Employee of: Employee of Janssen Research, Tom Gordon: None declared, Roberto Caricchio Grant/research support from: Financial grant from Janssen Research & Development, Douglas Veale: None declared, Ursula Fearon: None declared, Navin Rao Shareholder of: Janssen Pharmaceuticals, Employee of: Janssen Pharmaceuticals, Ling-Yang Hao Shareholder of: Employee of Janssen Research, Employee of: Employee of Janssen Research


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