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González-Serrano J, Serrano J, Sanz M, Torres J, Hernández G, López-Pintor RM. Efficacy and safety of a bioadhesive gel containing propolis extract, nanovitamin C and nanovitamin E on desquamative gingivitis: a double-blind, randomized, clinical trial. Clin Oral Investig 2023; 27:879-888. [PMID: 35900605 PMCID: PMC9889524 DOI: 10.1007/s00784-022-04653-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the efficacy of a gel-containing propolis extract, nanovitamin C, and nanovitamin E as adjuvants to professional plaque removal on desquamative gingivitis (DG). MATERIALS AND METHODS A randomized clinical trial was conducted on patients suffering DG due to mucocutaneous diseases. Patients received professional supragingival prophylaxis with oral hygiene instructions and were randomly assigned to use test or control gels as toothpaste and to apply it on DG lesions 3 times/day for 4 weeks. DG clinical score (DGCS), clinical periodontal variables, and visual analog scale (VAS) for pain and oral health impact profile (OHIP-14) were collected at baseline, 2 and 4 weeks. RESULTS Twenty-two patients were randomly assigned to test (n = 11) or control group (n = 11). Eighteen had diagnosis of oral lichen planus and four of mucous membrane pemphigoid. DGCS statistically decreased in both groups after treatment with no significant differences between groups. Clinical periodontal outcomes decreased in both groups, but no significant differences were observed. Periodontal variables statistically improved only in test group after treatment. VAS and OHIP-14 scores decreased in test and control groups without significant differences. However, only one test group showed a statistically significant decrease in VAS and OHIP-14 scores after treatment. No adverse effects were reported. CONCLUSIONS Test gel may alleviate DG and improve quality of life without side effects. CLINICAL RELEVANCE A gel-containing propolis extract, nanovitamin C, and nanovitamin E as adjuvants to mechanical debridement may improve both clinical and patient related outcomes in DG patients without side effects. CLINICAL TRIAL REGISTRATION The study protocol was registered at clinicaltrials.gov with the following number: NCT05124366 on October 16, 2021.
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Affiliation(s)
- José González-Serrano
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Julia Serrano
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Mariano Sanz
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Jesús Torres
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Gonzalo Hernández
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Rosa María López-Pintor
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Departamento de Especialidades Clínicas Odontológicas. Facultad de Odontología, Universidad Complutense de Madrid. Plaza Ramón Y Cajal S/N, 28040 Madrid, Spain
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Pemphigus for the Inpatient Dermatologist. CURRENT DERMATOLOGY REPORTS 2022. [DOI: 10.1007/s13671-022-00369-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Dolenc‐Voljč M, Povšič K, Kučič AC, Gašperšič R. Pemphigus vulgaris with refractory gingival ulcerations, successfully treated with rituximab—A case report. Clin Case Rep 2022; 10:e6321. [PMID: 36177086 PMCID: PMC9475132 DOI: 10.1002/ccr3.6321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/15/2022] Open
Abstract
A patient presented with ulcerations of the buccal mucosae, palate and gingiva. A gingival biopsy confirmed the diagnosis as pemphigus vulgaris. Despite medication with systemic corticosteroids and mycophenolate mofetil, desquamative gingivitis persisted. Adjunct treatment with rituximab was therefore introduced. Regular follow‐ups revealed no inflammatory gingival changes even 6 years later.
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Affiliation(s)
- Mateja Dolenc‐Voljč
- Department of Dermatovenereology, Faculty of Medicine University of Ljubljana Ljubljana Slovenia
| | - Katja Povšič
- Department of Oral Medicine and Periodontology, Faculty of Medicine University of Ljubljana Ljubljana Slovenia
| | - Alja Cmok Kučič
- Department of Oral Medicine and Periodontology, Faculty of Medicine University of Ljubljana Ljubljana Slovenia
| | - Rok Gašperšič
- Department of Oral Medicine and Periodontology, Faculty of Medicine University of Ljubljana Ljubljana Slovenia
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Ide M, Karimova M, Setterfield J. Oral Health, Antimicrobials and Care for Patients With Chronic Oral Diseases – A Review of Knowledge and Treatment Strategies. FRONTIERS IN ORAL HEALTH 2022; 3:866695. [PMID: 35747534 PMCID: PMC9210540 DOI: 10.3389/froh.2022.866695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Periodontal and chronic oral mucosal diseases are significant life impacting conditions which may co-exist and synergistically act to cause more severe and widespread oral pathology with enhanced challenges in effective management. Clinicians regularly observe these effects and struggle to effectively manage both problems in many patients. There is limited understanding of many basic and applied scientific elements underpinning potentially shared aetiopathological features and management. Recent developments in translational science provide an opportunity to greater improve knowledge and subsequently care for patients with these problems.
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Lim YL, Bohelay G, Hanakawa S, Musette P, Janela B. Autoimmune Pemphigus: Latest Advances and Emerging Therapies. Front Mol Biosci 2022; 8:808536. [PMID: 35187073 PMCID: PMC8855930 DOI: 10.3389/fmolb.2021.808536] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/20/2021] [Indexed: 12/31/2022] Open
Abstract
Pemphigus represents a group of rare and severe autoimmune intra-epidermal blistering diseases affecting the skin and mucous membranes. These painful and debilitating diseases are driven by the production of autoantibodies that are mainly directed against the desmosomal adhesion proteins, desmoglein 3 (Dsg3) and desmoglein 1 (Dsg1). The search to define underlying triggers for anti-Dsg-antibody production has revealed genetic, environmental, and possible vaccine-driven factors, but our knowledge of the processes underlying disease initiation and pathology remains incomplete. Recent studies point to an important role of T cells in supporting auto-antibody production; yet the involvement of the myeloid compartment remains unexplored. Clinical management of pemphigus is beginning to move away from broad-spectrum immunosuppression and towards B-cell-targeted therapies, which reduce many patients’ symptoms but can have significant side effects. Here, we review the latest developments in our understanding of the predisposing factors/conditions of pemphigus, the underlying pathogenic mechanisms, and new and emerging therapies to treat these devastating diseases.
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Affiliation(s)
- Yen Loo Lim
- Department of Dermatology, National Skin Centre, Singapore
| | - Gerome Bohelay
- Department of Dermatology and INSERM U1125, Avicenne Hospital, Bobigny, France
| | - Sho Hanakawa
- A*STAR Skin Research Labs (ASRL), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Philippe Musette
- Department of Dermatology and INSERM U1125, Avicenne Hospital, Bobigny, France
| | - Baptiste Janela
- A*STAR Skin Research Labs (ASRL), Agency for Science, Technology and Research (A*STAR), Singapore
- Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Singapore
- A*STAR Infectious Diseases Labs, Agency for Science, Technology and Research (A*STAR), Singapore
- Singapore Immunology network, Agency for Science, Technology and Research (A*STAR), Singapore
- *Correspondence: Baptiste Janela,
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Macklis P, Adams K, Kaffenberger J, Kumar P, Krispinsky A, Kaffenberger B. The Association Between Oral Health and Skin Disease. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2020; 13:48-53. [PMID: 32884621 PMCID: PMC7442307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE: Oral health and mucocutaneous inflammation might play an important role in the etiopathogenesis of many skin diseases, especially those that also involve the oral mucosa. This review examines the relationship between skin conditions and various oral health metrics to better understand how oral diseases, especially periodontitis, might influence the development or prognosis of several conditions, including aphthous stomatitis, atopic dermatitis, lichen planus, pemphigus, pemphigoid, and psoriasis. METHODS: Using the PubMed search engine between Summer 2017 and Summer 2018, searches were performed for: oral health OR oral hygiene AND psoriasis, eczema, dermatitis, hidradenitis suppurativa, acne inversa, pyoderma gangrenosum, Sweet's syndrome, neutrophilic dermatosis, subcorneal pustular dermatosis, hives, urticaria, cutaneous lupus, pemphigoid, pemphigus, or lichen planus OR aphthous stomatitis. The abstract of articles written in English were reviewed by the investigators and selected for inclusion if the study involved a correlation between oral health/hygiene and skin disease. After studies were included, the references were reviewed for additional relevant studies. Diseases listed in the search terms that were not ultimately discussed in this review did not produce any articles of relevance. RESULTS: Aphthous stomatitis is correlated with poor periodontal health and greater plaque accumulation. Atopic dermatitis shows an association with gingivitis, toothaches, and oral infections. Heavier enamel plaque burden and reduced oral care are implicated in the exacerbation of lichen planus. Mucous membrane pemphigoid and pemphigus are intimately influenced by oral health, underscoring the important role of good oral health and hygiene. Psoriasis presents a strong connection with oral streptococcal bacterial burden, has been shown to be improved or even cured with tonsillectomy, and has treatment outcomes that are generally associated with periodontal disease. CONCLUSION: Comorbid disease associations are frequently being reported in dermatology, spurring collaboration between multiple specialists and dermatologists. This review emphasizes a need for closer collaboration between dermatologists and dentists to treat several common skin diseases.
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Affiliation(s)
- Paul Macklis
- Mr. Macklis is with the Ohio State University College of Medicine in Columbus, Ohio
- Mr. Adams with with the University of Toledo College of Medicine in Toledo, Ohio
- Dr. Kumar is with the Division of Periodontology at the Ohio State University College of Dentistry in Columbus, Ohio
- Drs. J. Kaffenberger, Krispinsky, and B. Kaffenberger are with Ohio State University Wexner Medical Center in Columbus, Ohio
| | - Kevin Adams
- Mr. Macklis is with the Ohio State University College of Medicine in Columbus, Ohio
- Mr. Adams with with the University of Toledo College of Medicine in Toledo, Ohio
- Dr. Kumar is with the Division of Periodontology at the Ohio State University College of Dentistry in Columbus, Ohio
- Drs. J. Kaffenberger, Krispinsky, and B. Kaffenberger are with Ohio State University Wexner Medical Center in Columbus, Ohio
| | - Jessica Kaffenberger
- Mr. Macklis is with the Ohio State University College of Medicine in Columbus, Ohio
- Mr. Adams with with the University of Toledo College of Medicine in Toledo, Ohio
- Dr. Kumar is with the Division of Periodontology at the Ohio State University College of Dentistry in Columbus, Ohio
- Drs. J. Kaffenberger, Krispinsky, and B. Kaffenberger are with Ohio State University Wexner Medical Center in Columbus, Ohio
| | - Purnima Kumar
- Mr. Macklis is with the Ohio State University College of Medicine in Columbus, Ohio
- Mr. Adams with with the University of Toledo College of Medicine in Toledo, Ohio
- Dr. Kumar is with the Division of Periodontology at the Ohio State University College of Dentistry in Columbus, Ohio
- Drs. J. Kaffenberger, Krispinsky, and B. Kaffenberger are with Ohio State University Wexner Medical Center in Columbus, Ohio
| | - Andrew Krispinsky
- Mr. Macklis is with the Ohio State University College of Medicine in Columbus, Ohio
- Mr. Adams with with the University of Toledo College of Medicine in Toledo, Ohio
- Dr. Kumar is with the Division of Periodontology at the Ohio State University College of Dentistry in Columbus, Ohio
- Drs. J. Kaffenberger, Krispinsky, and B. Kaffenberger are with Ohio State University Wexner Medical Center in Columbus, Ohio
| | - Benjamin Kaffenberger
- Mr. Macklis is with the Ohio State University College of Medicine in Columbus, Ohio
- Mr. Adams with with the University of Toledo College of Medicine in Toledo, Ohio
- Dr. Kumar is with the Division of Periodontology at the Ohio State University College of Dentistry in Columbus, Ohio
- Drs. J. Kaffenberger, Krispinsky, and B. Kaffenberger are with Ohio State University Wexner Medical Center in Columbus, Ohio
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Dal Prá KJ, de Assis Tristão SDSS, Franco JB, Matias DT, Carrillo CM, de Melo Peres MPS, Ribas PF. Oral management of pemphigus vulgaris in the intensive care unit. SPECIAL CARE IN DENTISTRY 2020; 40:280-284. [PMID: 32162360 DOI: 10.1111/scd.12454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 01/13/2023]
Abstract
Pemphigus vulgaris (PV) is a rare and potentially lethal autoimmune disease that affects the skin and mucous membranes. Injuries caused by the disease cause pain, risk of infection, and other complications that result in a high mortality rate. Frequently, management of the PV requires intensive care and a multidisciplinary approach. Oral lesions of PV are usually the first clinical signs of the disease and the last lesions to heal, requiring treatment by a specialized dental team. The aim of this study was to report two clinical cases of PV with involvement of the oral mucosa. The patients were admitted to an intensive care unit, and underwent multidisciplinary management of their condition along with low-level laser therapy. Both cases demonstrated the importance of specialized dental care in improving the quality of life of patients with PV.
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Affiliation(s)
- Ketelin Juliane Dal Prá
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Juliana Bertoldi Franco
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Diogo Toledo Matias
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Camila Merida Carrillo
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Priscila Fernandes Ribas
- Division of Dentistry, Hospital das Clinicas, Medical School, University of São Paulo, São Paulo, Brazil
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8
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Mahmoudi H, Tavakolpour S, Azizzadeh‐Roodpishi S, Daneshpazhooh M. Desquamative gingivitis in a pemphigus vulgaris patient resistant to rituximab. Dermatol Ther 2020; 33:e13225. [DOI: 10.1111/dth.13225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/01/2019] [Accepted: 01/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences Tehran Iran
| | - Soheil Tavakolpour
- Autoimmune Bullous Diseases Research Center Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences Tehran Iran
| | - Shadi Azizzadeh‐Roodpishi
- Autoimmune Bullous Diseases Research Center Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences Tehran Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences Tehran Iran
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9
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Garcia-Pola MJ, Rodriguez-López S, Fernánz-Vigil A, Bagán L, Garcia-Martín JM. Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e136-e144. [PMID: 30818305 PMCID: PMC6441599 DOI: 10.4317/medoral.22782] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/22/2018] [Indexed: 12/27/2022] Open
Abstract
Background The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. Material and Methods The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. Results After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. Conclusions In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis. Key words:Desquamative gingivitis, oral hygiene, oral lichen planus, mucous membrane pemphigoid; pemphigus, plasma cell gingivitis.
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Affiliation(s)
- M-J Garcia-Pola
- Department of Oral Medicine, Faculty of Medicine and Sciences of the Health, Julian Clavería, 33006 Oviedo, Spain,
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Buonavoglia A, Leone P, Dammacco R, Di Lernia G, Petruzzi M, Bonamonte D, Vacca A, Racanelli V, Dammacco F. Pemphigus and mucous membrane pemphigoid: An update from diagnosis to therapy. Autoimmun Rev 2019; 18:349-358. [PMID: 30738958 DOI: 10.1016/j.autrev.2019.02.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 11/02/2018] [Indexed: 12/23/2022]
Abstract
Pemphigus diseases (PDs) and mucous membrane pemphigoid (MMP) are a group of immune-mediated mucocutaneous disorders clinically characterized by the formation of blisters, erosions and ulcers. The skin and mucous membranes are predominantly affected, with the oropharyngeal mucosa as the initially involved site. Ocular involvement is also a frequent feature of these diseases. Because of the considerable overlap in their clinical presentations, the diagnosis of PDs vs. MMP can be challenging. A recognition of their specific immunological and histopathologic features is crucial in the differential diagnosis. Treatment modalities include systemically administered corticosteroids, steroid-sparing immunosuppressive agents, and biologic therapies (rituximab, intravenous immunoglobulins, and anti-tumor necrosis factor agents). Topical, oral, conjunctival, or intralesional corticosteroids as well as anti-inflammatory drugs and antibiotics are prescribed as needed.
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Affiliation(s)
- Alessio Buonavoglia
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - Patrizia Leone
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - Rosanna Dammacco
- Department of Ophthalmology and Neuroscience, University of Bari Medical School, Bari, Italy
| | - Giuseppe Di Lernia
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, Section of Dentistry, University of Bari Medical School, Bari, Italy
| | - Domenico Bonamonte
- Department of Biomedical Sciences and Human Oncology, Dermatology Unit, University of Bari Medical School, Bari, Italy
| | - Angelo Vacca
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy
| | - Vito Racanelli
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy.
| | - Franco Dammacco
- Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine "Guido Baccelli", University of Bari Medical School, Bari, Italy.
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11
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Maderal AD, Lee Salisbury P, Jorizzo JL. Desquamative gingivitis. J Am Acad Dermatol 2018; 78:851-861. [DOI: 10.1016/j.jaad.2017.04.1140] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/30/2017] [Indexed: 10/17/2022]
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12
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Jascholt I, Lai O, Zillikens D, Kasperkiewicz M. Periodontitis in oral pemphigus and pemphigoid: A systematic review of published studies. J Am Acad Dermatol 2017; 76:975-978.e3. [DOI: 10.1016/j.jaad.2016.10.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/11/2016] [Accepted: 10/17/2016] [Indexed: 10/20/2022]
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13
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Sobocinski V, Dridi SM, Bisson C, Jeanne S, Gaultier F, Prost-Squarcioni C, Bernard P, Pascal F, Lefevre B, Weber P, Abasq C, Agbo-Godeau S, Joly P, Ingen-Housz-Oro S, Duvert-Lehembre S. [Oral care recommendations for patients with oral autoimmune bullous diseases]. Ann Dermatol Venereol 2016; 144:182-190. [PMID: 28011091 DOI: 10.1016/j.annder.2016.09.680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 08/14/2016] [Accepted: 09/23/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Autoimmune bullous diseases (AIBD) may cause chronic oral lesions that progress insidiously. AIMS To provide recommendations for optimal oral-dental management of patients presenting AIBD with oral involvement. PATIENTS AND METHODS In the absence of scientific studies with high levels of proof, these recommendations have been drawn up at two meetings by a committee of experts on AIBD comprising 7 dermatologists, 1 stomatologist, 1 maxillofacial surgeon, 2 odontologists and 4 parodontologists. RESULTS The oral lesions associated with AIBD may be classified into three grades of severity: severe (generalised erosive gingivitis affecting at least 30% of dental sites), moderate (localised erosive gingivitis affecting less than 30% of dental sites) and controlled (no erosive oral lesions). Good oral-dental hygiene suited to the severity of the oral lesions, must be practised continually by these patients so as to avoid the formation of dental plaque, which aggravates symptoms. Dental and parodontal care must be considered in accordance with the severity grade of the oral lesions: in severe cases, the dental plaque must be eliminated manually with a curette, but several types of care (descaling, treatment for tooth decay, non-urgent extractions, etc.) must be suspended until the grade of severity is moderate or until the disease is stabilised.
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Affiliation(s)
- V Sobocinski
- Clinique dermatologique, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
| | - S-M Dridi
- Service d'odontologie, hôpital Henri-Mondor, 51, avenue du maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - C Bisson
- Service d'odontologie, CHRU de Nancy, 29, avenue de Lattre-de-Tassigny, 54000 Nancy, France
| | - S Jeanne
- Service d'odontologie, CHRU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - F Gaultier
- Service d'odontologie, hôpital Henri-Mondor, 51, avenue du maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - C Prost-Squarcioni
- Service de dermatologie, hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France
| | - P Bernard
- Service de dermatologie, hôpital Robert-Debré, rue du général-Koening, 51100 Reims, France
| | - F Pascal
- Service de dermatologie, hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France
| | - B Lefevre
- Service d'odontologie, hôpital Robert-Debré, rue du général-Koening, 51100 Reims, France
| | - P Weber
- Service de dermatologie, hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France
| | - C Abasq
- Service de dermatologie, hôpital Morvan, 2, avenue maréchal-Foch, 29200 Brest, France
| | - S Agbo-Godeau
- Service de stomatologie et chirurgie maxillo-faciale, hôpital Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - P Joly
- Clinique dermatologique, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France
| | - S Ingen-Housz-Oro
- Service de dermatologie, hôpital Henri-Mondor, 51, avenue du maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - S Duvert-Lehembre
- Service de dermatologie, hôpital de Dunkerque, 130, avenue Louis-Herbeaux, 59240 Dunkerque, France
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Kumar SJ, Nehru Anand SP, Gunasekaran N, Krishnan R. Oral pemphigus vulgaris: A case report with direct immunofluorescence study. J Oral Maxillofac Pathol 2016; 20:549. [PMID: 27721634 PMCID: PMC5051317 DOI: 10.4103/0973-029x.190979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pemphigus vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes. The initial clinical manifestation is frequently the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin. The etiology of this disease still remains obscure although the presence of autoantibodies is consistent with an autoimmune disease. These antibodies are targeted against the adhesion proteins of keratinocytes, leading to acantholysis (disruption of spinous layer, leading to intraepidermal clefting) and blister formation. Because only oral lesions are present initially, the chances of misdiagnosing the disease as another condition are increased, leading to inappropriate therapy. In this article, we report a case of PV with only oral manifestations in a 36-year-old male.
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Affiliation(s)
| | - S P Nehru Anand
- Department of Oral Medicine, SRM Dental College, Chennai, Tamil Nadu, India
| | | | - Rajkumar Krishnan
- Department of Oral Pathology, SRM Dental College, Chennai, Tamil Nadu, India
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