OD 35 - Vesicle-bullous diseases

Question 1

What are the oral manifestations of pemphigus vulgaris?

Answer 1

Red erosions/ulcerations
Can affect whole oral mucosa
Can be from isolated blisters to severe desquamative gingivitis
Nikolsky’s sign = desquamative gingivitis forms blister and pops - heals without scarring

Question 2

What drug treatment is used to decrease mortality of pemphigus vulgaris (75->10%)?

Answer 2

Systemic steroids

Question 3

What drugs cause pemphigus vulgaris?

Answer 3

Drugs with sulfhydryl groups (THIO drugs) = penicillamine/ captopril
Non-thio drugs = rifampicin/ NSAIDs/ ACEIs

Question 4

What are the oral manifestations of paraneoplastic pemphigus?

Answer 4

Intra-epidermal blisters
Erosions of oral cavity - most severe, sensitive and intense
Associated with neoplasia and B-cell lymphoproliveratice disorders

Question 5

What is MMP (mucous membrane pemphigoid)?

Answer 5

Subepithelial blistering diseases affecting mucous membranes

Question 6

What are the clinical features of MMP (mucous membrane pemphigoid)?

Answer 6

Oral lesions have chronic course with erythematous patches, blisters, erosions, nikolsky’s sign may be +ve
Ocular and skin involvement also - can be life threatening