Palabras clave
penfigoide de membranas mucosas. Manifestaciones orales
Cómo citar
PENFIGOIDE DE MEMBRANAS MUCOSAS: A PROPÓSITO DE DOS CASOS CLÍNICOS. (2010). Odontoestomatología, 12(15), 13-24. https://odon.edu.uy/ojs/index.php/ode/article/view/222
Resumen
El penfigoide de membranas mucosas representa un heterogéneo grupo de enfermedades ampollares, autoinmunes y crónicas, que afecta las mucosas y /o la piel. Es una patología que origina como secuelas, cicatrices que motivan importantes incapacidades funcionales en las mucosas involucradas, provocando ceguera, dificultades en la masticación, la deglución o en la respiración.
Su diagnóstico, tratamiento y control deben ser realizados por un equipo multidisciplinario.
Se presentan dos casos clínicos de penfigoide de membranas mucosas de localización oral, por considerarlos de interés, dadas sus manifestaciones clínicas y la diferente evolución en cada uno de ellos. Se describen los métodos de diagnóstico y tratamientos durante 4 años de seguimiento y control, realizados en la Cátedra de Semiología y Patología BMF, Clínica de Estomatología de la Facultad de Odontología. Universidad de la República.
Referencias
1 - The First International Consensus on Mucous Membrane Pemphigoid. Arch. Dermatol. 2002. vol 138. 370-379
2 – Grinspan D. Enfermedades de la boca. T. 3. Editorial Mundi. B. Aires.1975: 1349 –1457
3- Thost A. Der chronische schleimhautpemphigus der oberen luftwege. Arch. Laryng u Rhin. 1911; 25: 459-78
4- Civatte A. Le diagnostic des dermatosis bulleuses au laboratoire. Arch. Belg. Derm Syph. 1949 ; 5 : 273 – 5
5- Lever W F. Pemphigus. A histopathologic study. Arch Dermatol. 1951; 64:727-53
6 - Jablonska E, Bolgert M. Pemphigus bucal et oculaire. Bull Soc Franc Derm 1957 ;65 :7-9
7 – Chan L et al. The First International Consensus on Mucous Membrane Pemphigoid. Arch. Dermatol. 2002;138:370 - 379
8 - Thome JE. Anhalt GJ. Mucous membrane pemphigoid and pseudopemphigoid. Ophthlmology.2004. 111:45-52
9- Ahmed AR, Hombal SM. Cicatricial pemphigoid. Int. J. Dermatol.1986, 25: 90-
10- Silverman S Gorsky M, Lozada-Nur F. Oral mucous membrane pemphigoid. A study of sixty five patients. Oral Surg. Oral Med. Oral Pathol. 1986. 61:233-237
11- Moy W, Kumar V. Cicatricial pemphigoid. A case of onset at age 5. J. Periodontol. 1986; vol. 57:39-45
12- Harrry D. Oral and maxillofacial surgery clinics of North America. Cutaneous and mucous membrane lesions of the head and neck, diagnosis and management. 1998. 117-20
13- Fleming TE, Korman NJ. Cicatrizal pemphigoid. J Am Acad Dermatol. 2000; 43: 527 - 663
14- Setterfield J. Shirlaw P. Cicatricial pemphigoid: serial titres of circulating Ig. G and Ig. A antibasement membrane antibodies correlate with disease activity. Br J. Dermatol. 1999; 140:645-650
15 – Carrozzo M, Fasano M. Hla-DQB1 alleles in Italian patients with mucous membrane pemphigoid predominantly affectins the oral cavity. Br J Dermatol.2001; 145:805 – 808
16 – Laskaris G, Satriano R.. Drug induced blistering oral lesions. Clin. Dermatol.1993; 11: 545- 550
17 – Sollecito TP, Paresi E. Mucous membrane pemphigoid. The Dental Clinics of North America. 2005; 49: 91 – 106
18 – Azizi A, Lawaf S. The management of oral mucous membrane pemphigoid with dapsone and topical corticosteroid.J. Oral Pathol Med. 2008; 37:341 – 344
19 – Neff A, Turner M, Mutasim D. Therapeutics strategies in mucous membrane Pemphigoid. Therapeutics and Clinical Risk Management.2008;4(3):617 - 626
20 – Chan LS, Fine JD, Briggaman RA. Identification and partial characterization of a novel 105-KDalton lower lamina lucida autoantigen associated with a novel immune-mediated subepidermal blistering disease. J. Invest Dermatol. 1993; 101: 262 – 267
21- Bernard P, Vaillant L. Incidence and distribution of subepidermal autoinmmune bullous skin diseases in three French regions. Bullous French Study Group. Arch Dermatol. 1995; 131:48-52
22- Mondino BJ, Brown SI. Ocular cicatricial pemphigoid. Ophtalmology 1981; 88: 95-100
23 - Daniels T, Quadra-White C. Direct inmunofluorescence in oral mucosal disease: a diagnostic analysis of 130 cases. Oral Surg Oral Med Oral Pathol. 1981; 51:123 –134
24 - Ahmed A, Hombal S. Cicatricial pemphigoid. Int J Dermatol. 1991; 25: 90 - 96 The clinical, histopathological and immunological aspects and current therapeutic concepts. Minerva Stomatol. 1996; 45: 455 – 463
25 – Helander S, Rogers R. The sensitivity and specificity of direct immunofluorescence testing in disorders of mucous membranes. J Am Acad Dermatol 1994; 30: 65 – 75
26- Carrozzo M, Broccoletti R, Carbone M. Pemphigoid of the mucous membranes. The clinical, histopathological and immunological aspects and current therapeutic concepts. Minerva Stomatol. 1997; 45:455 - 463
27 - Fleming T, Korman N. Cicatricial pemphigoid. J. Am Acad Dermatol. 2000; 43: 591 - 594
28 - Musa N, Kumar V. Oral pemphigoid masquerading as necrotizing ulcerative gingivitis in a child. J Periodontol. 2002; 73: 657- 6327
29- Nisengard R, Neiders M. Desquamative lesions of the gingiva. J. Periodontol. 1981; 52:500-10
30- Robison J, Odom R. Bullous pemphigoid in children. Arch Dermatol. 1978; 114:899 -900
31- Alkan A, Gunhan O, Otan F. A clinical study of oral mucous membrane pemphigoid. J Int Med Res. 2003; 31:340 – 344
32- Stoopler E, Sollecito T, DeRossi S. Descamative gingivitis: early presenting symptom of mucocutaneous desease. Quintessence Int. 2003; 34: 582 – 586
33- Lamey P, Rees T. Mucous membrane pemphigoid. Treatment experience at two institutions. Oral Surg Oral Med Oral Pathol. 1992; 74: 50 - 53
34- Sami N, Bhol K. Simultaneous presence of mucous membrane pemphigoid and pemphigus vulgaris: molecular characterization of both autoantibocies. Clin Immunol. 2001;100:219 - 227
35- Nayar W, wojnarowska F. Association of autoimmunity and cicatricial pemphigoid :is there an immunogenetic basis?. J Am Acad Dermatol.1991; 2 :1011- 1015
36- Malik M, Gúrcan H, Ahmed A. Coexistence of mucous membrane pemphiglid and connective tissue disease. Clin Exp Dermatol. 2009; 1: 195 - 6
37- Egan C, Lazarova Z. Anti-epilegrin cicatricial pemphigoid: clinical findings, inmunopathogenesis and significant associations. Medicine 2003; 82:177-86
38- Sivalingam V, Shields Cl. Squamous cell caracinoma of the conjunctiv assoaciated with benign membrane pemphigoid. Ann Ophthalmol. 1990; 22:106-9
39- Gibson G, Daoud M. Anti-epilegrin (laminin 5) cicatricial pemphigoid and lung carcinoma: coincidence o association?. Br J Dermatol. 1997; 137: 780-2
40- Taniuchi K, Takata M, et al. Antiepilegrin (laminin-5)cicatricial pemphigoid associated with an underlying gastric carcinoma producing laminin5. Br J Dermatol. 1999; 140: 696-700
41-Fujimoto W, Ishida –Yamaoto A, et al. Antiepilegrin cicatricial pemphigoid: a case associated with gastric carcinoma .Br J Dermatol. 1998; 139: 682-7
42- Bagan J. Muzio L, Scully C. Mucous membrane pemphigoid. Oral Diseases. 2005:11:197 – 218
43- Lozada-Nur F, Miranda C. Double-blind clinical trial of 0.05% clobetasol propionate ointment in orabase and 0.05% fluocinonide ointment in orabase in the treatmente of patients with oral vesiculo erosive diseases. Oral Surg Oral Med Oral Pathol.1994; 77: 598 – 604
44- Gonzalez-Moles M, Ruiz- Avila I. Treatment of severe erosive gingival lesions by topical application of clobetasol propionate in custom trays. Oral Surg Oral Med Oral Pathol. 2003; 95: 688 – 692
2 – Grinspan D. Enfermedades de la boca. T. 3. Editorial Mundi. B. Aires.1975: 1349 –1457
3- Thost A. Der chronische schleimhautpemphigus der oberen luftwege. Arch. Laryng u Rhin. 1911; 25: 459-78
4- Civatte A. Le diagnostic des dermatosis bulleuses au laboratoire. Arch. Belg. Derm Syph. 1949 ; 5 : 273 – 5
5- Lever W F. Pemphigus. A histopathologic study. Arch Dermatol. 1951; 64:727-53
6 - Jablonska E, Bolgert M. Pemphigus bucal et oculaire. Bull Soc Franc Derm 1957 ;65 :7-9
7 – Chan L et al. The First International Consensus on Mucous Membrane Pemphigoid. Arch. Dermatol. 2002;138:370 - 379
8 - Thome JE. Anhalt GJ. Mucous membrane pemphigoid and pseudopemphigoid. Ophthlmology.2004. 111:45-52
9- Ahmed AR, Hombal SM. Cicatricial pemphigoid. Int. J. Dermatol.1986, 25: 90-
10- Silverman S Gorsky M, Lozada-Nur F. Oral mucous membrane pemphigoid. A study of sixty five patients. Oral Surg. Oral Med. Oral Pathol. 1986. 61:233-237
11- Moy W, Kumar V. Cicatricial pemphigoid. A case of onset at age 5. J. Periodontol. 1986; vol. 57:39-45
12- Harrry D. Oral and maxillofacial surgery clinics of North America. Cutaneous and mucous membrane lesions of the head and neck, diagnosis and management. 1998. 117-20
13- Fleming TE, Korman NJ. Cicatrizal pemphigoid. J Am Acad Dermatol. 2000; 43: 527 - 663
14- Setterfield J. Shirlaw P. Cicatricial pemphigoid: serial titres of circulating Ig. G and Ig. A antibasement membrane antibodies correlate with disease activity. Br J. Dermatol. 1999; 140:645-650
15 – Carrozzo M, Fasano M. Hla-DQB1 alleles in Italian patients with mucous membrane pemphigoid predominantly affectins the oral cavity. Br J Dermatol.2001; 145:805 – 808
16 – Laskaris G, Satriano R.. Drug induced blistering oral lesions. Clin. Dermatol.1993; 11: 545- 550
17 – Sollecito TP, Paresi E. Mucous membrane pemphigoid. The Dental Clinics of North America. 2005; 49: 91 – 106
18 – Azizi A, Lawaf S. The management of oral mucous membrane pemphigoid with dapsone and topical corticosteroid.J. Oral Pathol Med. 2008; 37:341 – 344
19 – Neff A, Turner M, Mutasim D. Therapeutics strategies in mucous membrane Pemphigoid. Therapeutics and Clinical Risk Management.2008;4(3):617 - 626
20 – Chan LS, Fine JD, Briggaman RA. Identification and partial characterization of a novel 105-KDalton lower lamina lucida autoantigen associated with a novel immune-mediated subepidermal blistering disease. J. Invest Dermatol. 1993; 101: 262 – 267
21- Bernard P, Vaillant L. Incidence and distribution of subepidermal autoinmmune bullous skin diseases in three French regions. Bullous French Study Group. Arch Dermatol. 1995; 131:48-52
22- Mondino BJ, Brown SI. Ocular cicatricial pemphigoid. Ophtalmology 1981; 88: 95-100
23 - Daniels T, Quadra-White C. Direct inmunofluorescence in oral mucosal disease: a diagnostic analysis of 130 cases. Oral Surg Oral Med Oral Pathol. 1981; 51:123 –134
24 - Ahmed A, Hombal S. Cicatricial pemphigoid. Int J Dermatol. 1991; 25: 90 - 96 The clinical, histopathological and immunological aspects and current therapeutic concepts. Minerva Stomatol. 1996; 45: 455 – 463
25 – Helander S, Rogers R. The sensitivity and specificity of direct immunofluorescence testing in disorders of mucous membranes. J Am Acad Dermatol 1994; 30: 65 – 75
26- Carrozzo M, Broccoletti R, Carbone M. Pemphigoid of the mucous membranes. The clinical, histopathological and immunological aspects and current therapeutic concepts. Minerva Stomatol. 1997; 45:455 - 463
27 - Fleming T, Korman N. Cicatricial pemphigoid. J. Am Acad Dermatol. 2000; 43: 591 - 594
28 - Musa N, Kumar V. Oral pemphigoid masquerading as necrotizing ulcerative gingivitis in a child. J Periodontol. 2002; 73: 657- 6327
29- Nisengard R, Neiders M. Desquamative lesions of the gingiva. J. Periodontol. 1981; 52:500-10
30- Robison J, Odom R. Bullous pemphigoid in children. Arch Dermatol. 1978; 114:899 -900
31- Alkan A, Gunhan O, Otan F. A clinical study of oral mucous membrane pemphigoid. J Int Med Res. 2003; 31:340 – 344
32- Stoopler E, Sollecito T, DeRossi S. Descamative gingivitis: early presenting symptom of mucocutaneous desease. Quintessence Int. 2003; 34: 582 – 586
33- Lamey P, Rees T. Mucous membrane pemphigoid. Treatment experience at two institutions. Oral Surg Oral Med Oral Pathol. 1992; 74: 50 - 53
34- Sami N, Bhol K. Simultaneous presence of mucous membrane pemphigoid and pemphigus vulgaris: molecular characterization of both autoantibocies. Clin Immunol. 2001;100:219 - 227
35- Nayar W, wojnarowska F. Association of autoimmunity and cicatricial pemphigoid :is there an immunogenetic basis?. J Am Acad Dermatol.1991; 2 :1011- 1015
36- Malik M, Gúrcan H, Ahmed A. Coexistence of mucous membrane pemphiglid and connective tissue disease. Clin Exp Dermatol. 2009; 1: 195 - 6
37- Egan C, Lazarova Z. Anti-epilegrin cicatricial pemphigoid: clinical findings, inmunopathogenesis and significant associations. Medicine 2003; 82:177-86
38- Sivalingam V, Shields Cl. Squamous cell caracinoma of the conjunctiv assoaciated with benign membrane pemphigoid. Ann Ophthalmol. 1990; 22:106-9
39- Gibson G, Daoud M. Anti-epilegrin (laminin 5) cicatricial pemphigoid and lung carcinoma: coincidence o association?. Br J Dermatol. 1997; 137: 780-2
40- Taniuchi K, Takata M, et al. Antiepilegrin (laminin-5)cicatricial pemphigoid associated with an underlying gastric carcinoma producing laminin5. Br J Dermatol. 1999; 140: 696-700
41-Fujimoto W, Ishida –Yamaoto A, et al. Antiepilegrin cicatricial pemphigoid: a case associated with gastric carcinoma .Br J Dermatol. 1998; 139: 682-7
42- Bagan J. Muzio L, Scully C. Mucous membrane pemphigoid. Oral Diseases. 2005:11:197 – 218
43- Lozada-Nur F, Miranda C. Double-blind clinical trial of 0.05% clobetasol propionate ointment in orabase and 0.05% fluocinonide ointment in orabase in the treatmente of patients with oral vesiculo erosive diseases. Oral Surg Oral Med Oral Pathol.1994; 77: 598 – 604
44- Gonzalez-Moles M, Ruiz- Avila I. Treatment of severe erosive gingival lesions by topical application of clobetasol propionate in custom trays. Oral Surg Oral Med Oral Pathol. 2003; 95: 688 – 692