Pemphigus vulgaris

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UST - Touch Of Creativity …

UST - Touch Of Creativity
Oral Medicine
pemphigus vulgaris
By: Dr.Shaima Alkasem

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  • 1. Definition : An autoimmune vesiculobullous blistering disease characterized by intra-epithelial blister formation.
  • 2. Aetiopathogenesis : Circulating autoantibodies of (IgG) type target the desmosomal complexes, Desmoglein 3 and 1 .
  • 3. Epidemiology : - Equal Incidence rate in both genders . - Most patient presenting during the 4th and 5th decades of life . - Genetic and ethnic factors: Ashkenazic Jews and Mediterranean patients .
  • 4. Clinical features : - Painful ulcers . - Intra oral: Bullae apprear on any part of oral mucosa and becomes ulcers, fig (1-2) . - Extra oral : blisters appear on skin of face, back or chest, fig(3) . - Positive Nikolsky`s sign .
  • 5. Clinical features : Fig(1): ulcers in lower lip
  • 6. Clinical features : Fig(2): ulcers in buccal mucosa
  • 7. Clinical features : Fig(3): ulcers in skin of back
  • 8. Diagnosis : - Direct Immunofluorescence fig(4) . - Indirect Immunofluorescence .
  • 9. Diagnosis : fig(4): Direct Immunofluorescence .
  • 10. Differential Diagnosis : - Mucous membrane pemphigoid . - Erythema Multiforme . - Paraneoplastic pemphigus . - Pemphigus vegetans .
  • 11. Treatment : Based on disease severity : * Mild : - Topical corticosteroids .
  • 12. Treatment : * Moderate to sever : systemic agents include : - prednisone . - mycophenolate mofetil . - azathioprine . - cyclosporine .