Cicatricial pemphigoid presenting as desquamative gingivitis
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Cicatricial pemphigoid, also known as mucous membrane pemphigoid, is a group of chronic, blistering, mucocutaneous autoimmune diseases in which tissue-bound autoantibodies are directed against one or more components of the basement membrane. Here, presents a case of cicatricial pemphigoid presenting as desquamative gingivitis in a 42-year-old female patient.

This 42-year-old female patient came to oral mucosal disease treatment of pain and gingival bleeding when tooth brushing. Oral examination revealed erosive lesions on the buccal gingivae of teeth 24, 25, 26, 34, 35, 36, 44, and 45. The erosive lesions were sensitive to hot and spicy food and present for 4 months. The patient was referred to an oral surgeon for biopsy under the clinical impression of desquamative gingivitis. A small piece of the perilesional buccal gingival tissue near tooth 24 was removed and sent for histopathological examination.

Microscopically, it showed a split between the stratified squamous epithelium and the underlying connective tissue with a moderate chronic inflammatory cell infiltrate in the superficial region. A small subepithelial vesicle with the edematous stratified squamous epithelium at the roof and the inflamed connective tissue at the base was also found near the margin of the tissue specimen. Therefore, the final histopathological diagnosis was cicatricial pemphigoid.

The mild oral lesions of cicatricial pemphigoid can be treated by topical application of corticosteroid ointment 2 to 3 times per day. For more severe cicatricial pemphigoid oral lesions, systemic administration of a relatively large dose of prednisolone (30mg–50mg per day) for a week usually can control the disease. The treatment outcome can be maintained by alternate-day oral administration of a low dose of prednisone (5mg per day).

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