Oral pemphigoid

Angina bullosa haemorrhagica: presentation of eight new cases and a review of the literature

Angina bullosa haemorrhagica (ABH) describes the acute and sometimes painful onset of oral blood-filled vesicles and bullae not attributable to blood dyscrasia, vesiculo-bullous disorders, systemic diseases or other known causes. The haemorrhagic bullae spontaneously burst after a short time resulting in ragged, often painless, superficial erosions that heal spontaneously within 1 week without scarring. Although the pathogenesis is still unclear, ABH seems to be a multifactorial phenomenon: dental or functional trauma seems to be the major provoking factor. The lesions of ABH can be easily confused with other mucosal diseases. It is important that the presentation of this benign disorder is distinguished from other more serious disorders with similar presenting features. The aim of this paper is to report the clinical features of eight cases of ABH, in an attempt to distinguish ABH from other blistering diseases of oral mucosa and to describe their management.

Angina bullosa hemorrhagica: an unusual problem following periodontal therapy

Angina bullosa hemorrhagica (ABH) describes benign subepithelial oral blood blisters not attributable to a systemic disorder. Little is known about the pathogenesis of ABH, although most cases have been associated with mild trauma prior to appearance of the lesion. This report discusses the clinical and histopathologic features of ABH which appeared after routine scaling and root planing.

Mucous membrane pemphigoid. Treatment experience at two institutions

The initial oral findings and treatment in 50 cases of mucous membrane pemphigoid are presented. Histologic and immunologic studies were undertaken in each case to confirm the clinical diagnosis. The treatments prescribed are summarized and illustrate that topical steroids are effective, but in some cases systemic steroid therapy with or without other immunologically active drugs is required. A significant number of patients had extraoral manifestations of the disorder.

Mucous membrane pemphigoid: a disease of the elderly

Mucous membrane pemphigoid (MMP) is a vesiculo-bullous, mucocutaneous disease that generally affects elderly people. The diagnosis of mucous membrane pemphigoid may be overlooked since the disease is often confined to the mouth and desquamative gingivitis may be the only symptom. Gerodontic patients with this condition are often diagnosed as having "desquamative gingivitis" without obtaining the proper therapy to control chronic pain and effect disease remission. The discomfort associated with eating may prevent many elderly patients from obtaining adequate nutrition. Topical and/or systemic corticosteroid therapy are the only available methods of managing this condition. Immunologic studies support the autoimmune nature of MMP and infer that it may be a variant of bullous pemphigoid.

Desquamative gingivitis: preliminary observations with tetracycline treatment

Fourteen patients admitted to our clinic were found to have desquamative gingivitis. They were treated with doxycycline monohydrate, a semisynthetic tetracycline, for 6 to 8 weeks. The gingival lesions were recorded photographically and were classified according to severity by means of a four-graded mucosal index system. Biopsies for histologic and immunohistochemical examination were taken initially. Symptoms and clinical changes of the mucosa were recorded during the treatment period. Initial and final mucosal index scores were compared. A statistically significant improvement was obtained after tetracycline treatment.

Gingival manifestations of childhood cicatricial pemphigoid

Cicatricial pemphigoid (CP) is found almost exclusively among middle-aged and elderly persons. This article describes a rare case of CP in a 14-year-old girl; it appeared on the mandibular anterior gingiva as desquamative gingivitis. Histologic examination of the lesions showed a subepithelial bulla. Immunofluorescence of gingival biopsy revealed immunoglobulin G, protein C3, and faint immunoglobulin A deposition along the basement membrane zone; results for normal skin were negative. Indirect immunofluorescence produced negative results. There are only six documented cases of childhood CP previously reported in the literature. The clinical and immunologic features of these cases are reviewed.