scholarly journals Prevalence of oral lesions in pemphigus vulgaris: a retrospective study

2019 ◽  
Vol 5 (3) ◽  
pp. 528
Author(s):  
Vinay K. N. ◽  
Gouhare Afshan
Keyword(s):  
Retrospective Study ◽  
Demographic Data ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Oral Lesions ◽  
Initial Manifestation ◽  
Course Of Disease ◽  
Number Of Patients ◽  
Duration Of Disease ◽  
Time Of Presentation

<p class="abstract"><strong>Background:</strong> Pemphigus vulgaris is an autoimmune vesiculobullous disease characterized by vesicles and or bullae affecting skin and mucosa. Oral lesions are the first manifestation of the disease in majority of cases according to literature. This study is conducted to know the prevalence of oral lesions in pemphigus vulgaris patients at the time of presentation.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study. Departmental records were evaluated from January 2013 to January 2018. All the demographic data of pemphigus vulgaris patients at the time of first presentation, duration of disease, were assessed and tabulated. The clinical data of these patients during their subsequent visits to clinic were assessed for development of new oral lesions during course of disease.<strong></strong></p><p class="abstract"><strong>Results:</strong> Total number of patients were 55. The mean age was 42.5 years. 12 (21.8%) were males and 4 (78.1%) were females. Out of 55 patients 37 (67.27%) cases had oral involvement and 18 (32.72%) cases did not have oral lesions at the time of presentation. Out of 37 patients who had oral lesions, 34 (91.89%) patients had both oral and skin lesions and 3 (08.10%) patients had only oral lesions at the time of presentation. Out of the18 patients with no oral lesions, 3 (16.66%) patients developed oral lesions within 3 months. Total number of patients with oral lesions out of 55 were 40 (72.7%).</p><p class="abstract"><strong>Conclusions:</strong> Our study shows that oral lesions as initial manifestation of pemphigus vulgaris is 67.2%.</p>

scholarly journals Anti-Thyroid Peroxidase Antibody in Vitiligo: A Prevalence Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
R. Dash ◽  
A. Mohapatra ◽  
B. S. Manjunathswamy
Keyword(s):  
Thyroid Disease ◽  
Demographic Data ◽  
Thyroid Autoimmunity ◽  
Cross Sectional Study ◽  
Thyroid Peroxidase ◽  
Cross Sectional ◽  
Thyroid Peroxidase Antibody ◽  
Number Of Patients ◽  
Antibody Positivity ◽  
Time Of Presentation

Aim.The aim of the study was to study the relation of vitiligo with demographic data like age, sex, and duration and determine the prevalence of thyroid autoimmunity in vitiligo patients.Materials and Methods.This study was a cross sectional study consisting of 100 patients clinically diagnosed (old and new) as having vitiligo irrespective of age or sex. Patients with known thyroid disease on supplementation therapy, or who had undergone thyroid surgery, those on antithyroid medication, patients with other causes of leukoderma, and cases who do not provide informed consent were excluded from the study. Serum TSH and anti-TPO antibodies were measured in all the patients.Results.The prevalence of anti-TPO antibody positivity was found to be 28%.Conclusion.According to our study, none of our vitiligo patients had symptoms or signs of thyroid disease at the time of presentation but, on biochemical evaluation, anti-TPO antibodies were found in a considerable number of patients. Hence, we recommend screening of these patients with thyroid antibodies.

scholarly journals Detection of Autoantibodies against Recombinant Desmoglein 1 and 3 Molecules in Patients with Pemphigus vulgaris: Correlation with Disease Extent at the Time of Diagnosis and during Follow-Up

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Anna Belloni-Fortina ◽  
Diana Faggion ◽  
Barbara Pigozzi ◽  
Andrea Peserico ◽  
Matteo Bordignon ◽  
...  
Keyword(s):  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Response To Therapy ◽  
Cdna Clones ◽  
Disease Extent ◽  
Specific Test ◽  
Number Of Patients ◽  
Mucosal Involvement ◽  
Desmoglein 3

The recent availability of cDNA clones for pemphigus antigens has allowed the production of recombinant desmoglein 1 and desmoglein 3 molecules and the development of an ELISA approach in order to determine levels of antibodies to them. The aim of the study was to determine the relationship between autoantibodies levels and the extent of both mucosal and skin lesions in 20 patients with pemphigus vulgaris at the time of diagnosis and during follow-up. For the detection of autoantibodies by ELISA we used the recombinant proteins expressing overlapping sequences with the entire extracellular desmoglein 1 and desmoglein 3 domains. We showed that in presence of mucosal lesions there was a correlation between extension of mucosal involvement and autoantiboidies titres against both desmoglein 1 and desmoglein 3, whereas in presence of skin lesions there was a statistically significant correlation between extension of skin lesions and autoantibodies titres against desmoglein 3, but not against desmoglein 1. A not negligible number of patients showed variations of the desmoglein 3 autoantibodies titre which did not correlate with the severity of both cutaneous and mucosal involvement. Similar results were obtained analyzing autoantibodies titres against desmoglein 1. In conclusion, we believe that the utilization of recombinant desmoglein 1 and desmoglein 3 proteins by ELISA should be used with caution to monitor disease severity and response to therapy, although it remains a high specific test for the initial diagnosis of pemphigus and the identification of a change in the clinical phenotype of this condition.

scholarly journals Oral Manifestation in Patients diagnosed with Dermatological Diseases

2017 ◽  
Vol 18 (12) ◽  
pp. 1153-1158
Author(s):  
Meena Kulkarni ◽  
Sanjay G Thete ◽  
Atul P Nikam ◽  
Tejashree Mantri ◽  
Dhiraj Umbare ◽  
...  
Keyword(s):  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Oral Lesions ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Dermatological Diseases ◽  
Medical College ◽  
Oral Manifestation ◽  
Dermatological Disease ◽  
The Social

ABSTRACT Aim This study aimed to estimate the frequency of oral lesions in dermatological diseased patients attending the outpatient department of Pravara Rural Medical and Dental College and Hospital, Pravara Institute of Medical Sciences (Deemed University), Loni, Ahmednagar, Maharashtra, India, and the Department of Dermatology at Medical College, Ahmednagar, Maharashtra, India. Materials and methods A cross-sectional hospital-based study was conducted in Loni from October 2013 to January 2014. A total of 310 patients (mean age 37.2 ± 16 years, 61.2% males) completed an oral examination and a personal interview. Oral lesions were recorded. Biopsy and smear were used as adjuvant techniques for confirmation. Data were analyzed using Statistical Package for the Social Sciences (SPSS) (version 15.0.1). Results Of 310 cases (n = 310) observed for skin lesions, 99 cases were psoriasis (31.93%) and 68 cases were lichen planus (LP; 21.9%), followed by herpes zoster in 44 cases (14.1%), herpes simplex in 13 cases (4.1%), pemphigus vulgaris (PV) in 15 cases (4.8%), erythema multiforme (EM) in 8 cases (2.5%), bullous pemphigoid (BP) in 4 cases (1.2%), chicken pox in 3 cases (0.9%), eczema in 52 cases (16.7%), and nutritional deficiency and candidiasis in 2 cases (Table 1). Conclusion The dermatologic diseases studied frequently occur in the oral cavity. Among them, psoriasis was the most common dermatological disease, and LP frequently showed. Clinical significance This study also depicts that diagnosis and management of these oral lesions should also be carried out by oral clinicians so as to improve the oral health functioning during the course of the disease. The intraoral examination should be incorporated to the routine of dermatologic assistance as the oral manifestations can represent preliminary signs or can coexist with the diseases. How to cite this article Thete SG, Kulkarni M, Nikam AP, Mantri T, Umbare D, Satdive S, Kulkarni D. Oral Manifestation in Patients diagnosed with Dermatological Diseases. J Contemp Dent Pract 2017;18(12):1153-1158.

scholarly journals Modifications of pulse therapy in pemphigus: a retrospective study of 72 patients

2019 ◽  
Vol 5 (1) ◽  
pp. 150
Author(s):  
Neela V. Bhuptani ◽  
Khushbu P. Chauhan ◽  
Monal M. Jadwani ◽  
Pooja Raja
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Pemphigus Vulgaris ◽  
Pulse Therapy ◽  
Therapeutic Effects ◽  
Female Ratio ◽  
Number Of Patients ◽  
Iga Pemphigus ◽  
Cyclophosphamide Pulse ◽  
Therapy Protocol

<p class="abstract"><strong>Background:</strong> Pulse therapy defines as the administration of supra-pharmacologic doses of drugs in an intermittent manner to enhance the therapeutic effects and reduce the side effects. Dexamethasone-Cyclophosphamide pulse (DCP) therapy is known since 1986 but there are certain limitations due to side effects of cyclophosphamide.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was carried out where 72 patients of pemphigus were treated with modified pulse therapy like DCP, DAP, DMP from 2006-2016. Modifications were made in DCP therapy protocol and substitution of cyclophosphamide with either azathioprine or methotrexate in few patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Male to female ratio observed was 1:0.7. Majority of them belonged to age group of 31-40 years (41.66%) followed by 41-50 years (33.3%). Maximum number of patients had pemphigus vulgaris (86.1%) followed by pemphigus foliaceous (12.5%) and IgA pemphigus (1.38%). Good response was observed in patients who took pulse therapy regularly.</p><p class="abstract"><strong>Conclusions:</strong> Modifications to the original DCP therapy protocol were found to be very effective, useful and it shortened the duration of phase I. Side effects were minimal and manageable.</p>

scholarly journals Psychological Stress and Diabetes Mellitus As Complicating Factors in Management of Pemphigus Vulgaris

2017 ◽  
Vol 1 ◽  
Author(s):  
Ellis Eka Ramadian ◽  
Afi Savitri Sarsito
Keyword(s):  
Diabetes Mellitus ◽  
Psychological Stress ◽  
Systemic Disease ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Comprehensive Treatment ◽  
Oral Lesions ◽  
Her Family ◽  
Oral Rinse ◽  
Complicating Factors

<p class="AbstractContent"><strong>Introduction: </strong>Pemphigus vulgaris (PV) is an autoimmune disease with vesiculobullous lesions that attack the skin and mucosa including oral mucosa. There are some factors that can trigger the recurrence of PV; one of them is psychological stress. PV is treated using immunosuppressant agents like corticosteroids or other immunosuppressant drugs. Complete remission in PV often hard to achieve because of some trigger factors that is hard to control and systemic disease like diabetes mellitus (DM).</p><p class="AbstractContent"><strong>Objective: </strong>to discuss the management of oral lesions in persistent PV with psychological stress and DM as triggers. Case report: A 46 years old female diagnosed with PV had oral lesions that recurrent every time she had problems in her family. The patient also known to have DM. PV was treated in collaboration with Department of Dermatoveneorology, and she received corticosteroids and mycophenolate mofetil. We prescribed corticosteroid oral rinse with the dose according to oral condition and corticosteroid given for skin lesions. Oral lesions resolved after the patient was consulted to Department of Psychiatric for counselling and DM was controlled.</p><p class="AbstractContent"><strong>Conclusions: </strong>Systemic and psychological factors have important roles in remission of PV. Comprehensive treatment in collaboration with related departments is mandatory to achieve maximum benefits of healing.</p>

scholarly journals Simultaneous Oral and Umbilical Locations as a First Sign of Pemphigus Vulgaris

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Eya Moussaoui ◽  
Yassine Oueslati ◽  
Lamia Oualha ◽  
Mohamed Denguezli ◽  
Badreddine Sriha ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Early Treatment ◽  
Clinical Manifestations ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Oral Lesions ◽  
Cutaneous Lesions ◽  
Autoimmune Bullous Diseases ◽  
Bullous Diseases ◽  
Pemphigus Vegetans

The place of pemphigus vulgaris (PV) among autoimmune bullous diseases (AIBD) is well established. It is an acquired chronic, autoimmune, vesiculobullous disease in which IgG antibodies target desmosomal proteins to produce intraepithelial mucocutaneous blistering. The diagnosis is often challenging for the clinicians. It requires a combination of three major features: clinical, histopathological, and immunological. Clinically, oral lesions are the first manifestations of the disease in 50-90% of the patients with widespread blisters affecting the oral mucosa. On the skin, lesions are characterized by flaccid blisters that rapidly progress into erosions and crust formation. Umbilical lesions as a clinical manifestation of PV are peculiar and have rarely been reported, and they are not yet completely elucidated. Umbilical region involvement in patients with pemphigus was assessed in a limited study totalling just 10 patients. This localisation may be a valuable hint easing the diagnosis at the clinical level for patients with oral mucosal blisters. Dentists must be familiar with the clinical manifestations of PV to make an early diagnosis and start an early treatment which determines the prognosis of the disease. To the best of the authors’ knowledge, the coexistence of these lesions with the oral lesions as a first sign of PV in the absence of skin involvement was reported in only one case of pemphigus vegetans (PVe). In this paper, we describe an observation of a female patient that was diagnosed with PV that begun with simultaneous oral and umbilical locations which coexisted for a period of 4 months before the appearance of other cutaneous lesions. We highlight the role of dentists, by being familiar with the clinical manifestations of PV, to make an early diagnosis to start an early treatment which determines the prognosis of the disease and to follow closely the evolution of lesions to change treatment if required. We also discuss the clinical, histological, and immunological features of the disease that enabled the differential diagnosis as well as the appropriate therapeutic management.

scholarly journals Improving Treatment Outcome of Pemphigus Vulgaris on Vietnamese Patients by Using Desmoglein Elisa Test

2019 ◽  
Vol 7 (2) ◽  
pp. 195-197 ◽  
Author(s):  
Anh Tran Thi Van ◽  
Thuong Van Nguyen ◽  
Sau Nguyen Huu ◽  
Lan Pham Thi ◽  
Phuong Pham Thi Minh ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Chronic Disease ◽  
Antibody Level ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Elisa Test ◽  
Oral Lesions ◽  
Before And After ◽  
Antibody Levels

BACKGROUND: Pemphigus Vulgaris (PV) is a chronic disease, is characterized by the presence of flacid bullous in skin and mucosa. There are 2 main autoantibodies against desmoglein3 (Dsg3) and desmoglein1 (Dsg1). AIM: The aims of this study were to evaluate the before and after treatment outcome with corticosteroid, using Desmoglein ELISA test. METHOD: Forty patients with Pemphigus include 36 PV and 4 PF (28 women, 12 women) were enrolled. The titers of Dsg in pemphigus patients by using ELISA test were done before and 1-month treatment RESULTS: Both anti-Dsg1 and anti-Dsg3 levels were significantly reduced after treatment (P < 0.05). The severity of skin lesions was correlated with anti-Dsg1 antibody level and the severity of oral lesions was significantly correlated with anti-Dsg 3 antibody levels (p < 0.05) CONCLUSION: It is recommended that we can predict and improve the outcome of treatment by using Desmoglein ELISA test.

scholarly journals Pemphigus Vulgaris and its Comprehensive Management: Report of Two Cases and Literature Review

2021 ◽  
pp. 229-237
Author(s):  
Yadira V. Boza Oreamuno ◽  
Jorge González Quesada
Keyword(s):  
Dental Plaque ◽  
Pemphigus Vulgaris ◽  
Skin Lesions ◽  
Pharmacological Therapy ◽  
Oral Lesions ◽  
Local Factor ◽  
Comprehensive Management ◽  
Bacterial Plaque ◽  
Over Time ◽  
Management Report

In the oral cavity, gingiva lesions may occur that are not associated with bacterial plaque, which require adequate diagnosis and treatment. Desquamative gingivitis is usually related to mucocutaneous disorders, such as pemphigus vulgaris (PV), where oral lesions, including gingival lesions, may precede skin lesions. Management is multidisciplinary and treatment includes topical and systemic pharmacological therapy, require adequate control of dental plaque by the patient and strict supervision over time by the professional for the maintenance and stability of the gingival tissues. Two clinical cases of patients with a diagnosis of PV are presented, which were managed in a timely and integral way to control and stabilize the systemic and local factor.

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