Oral mucosal lesions in patients with pemphigus and pemphigoid skin diseases: a cross sectional study from Southern India

OBJECTIVE: To assess the prevalence of oral mucosal lesions in patients with pemphigus and pemphigoid diseases from Southern India. DESIGN AND METHODS: A cross-sectional hospital based study was conducted from August 2011 to July 2012. Patients with confirmed pemphigus and pemphigoid skin disease were selected and invited to participate in the study. Diagnostic procedures such as histopathological and immunofluorescence methods were performed to confirm the diagnosis. The results of the study were analyzed by SPSS software version 19.0 and presented as descriptive statistics. RESULTS: A total of 30 patients (Male 4, Female 26) with autoimmune blistering disease were selected for the present study. 60% (18 out of 30) patients showed oral mucosal manifestations. 46.66% (14 out of 30) presented with Pemphigus, and 53.33%(16 out of 30) patients presented with pemphigoid. The most common subtypes of pemphigus was Pemphigus vulgaris 71% (10 out of 14) among pemphigus, and bullous pemphigoid 87.5%(14 out of 16) among pemphigoid. In pemphigus, buccal mucosa (92.85%) was the most frequent site, and hard palate (12.5%) in pemphigoid. 78.57% of pemphigus, and 12.5% of pemphigoid patients revealed oral mucosa as initial site of disease process. CONCLUSION: The significance of diagnosing the oral lesions in earlier stage in dental practice may help in early intervention of disease and helps to reduce morbidity and mortality. The study also reinforced the multidisciplinary approach in diagnosis.

White lesions of the oral mucosa

A simple definition of a mucosal white lesion would be "a lesion which appears clinically whiter than the surrounding mucosa." Mucosal white lesions are to be taken seriously because a small proportion of these are known to possess malignant potential which often pose a diagnostic challenge even to an experienced clinician. Differentiation between white lesions with a potential is therefore of paramount importance. When in doubt, the clinician should always perform a biopsy of the lesion and seek a histopathologic report (AU)

Red lesions of the oral mucosa

Oral soft tissue lesions, which clinically appear red, are common. These lesions may present themselves in different clinical forms. They may be patchy, spotted, macular, papular, nodular, localized, diffuse, single, multiple and so on. Lesions that appear red may be considered primary when they appear when they appear as a result of local causes. They are secondary when their occurence is a result of systemic pathology. It is not uncommon that red lesions may be associated with pigmented or white lesions. In this chapter, commonly encountered red lesions of the oral mucosa are briefly discussed (AU)

Vesiculo-bullous lesions of the oral mucosa

Oral mucosa frequently manifests a variety of lesions that are fluid-filled and raised. When such lesions are ovoid and about 0.5 cm, these are generally referred to as bullae (AU)

Cancrum oris (noma) in a patient with acute lymphoblastic leukaemia. A complication of chemotherapy induced neutropenia

Cancrum oris (noma) has been most commonly described in malnourished debilitated children with poor oral hygiene following systemic childhood infections such as measles, pertussis or scarlet fever. We describe a patient who developed this condition during a period of profound neutropenia following cytotoxic chemotherapy for acute lymphoblastic leukaemia(AU)

Reverse smoking and its effects on the hard palate: a case report

Reverse smoking is a habit that is endemic in many Indian, South American and Caribbean communities. Two case reports of reverse smoking are presented in this paper. Although it causes characteristic changes in the palate, the role of reverse smoking in oral cancer is unclear. No clinical studies are available on reverse smoking using commercially available cigarettes. (AU)

Primary malignant melanoma of the maxillary gingiva in a 4-year-old girl

A primary buccal mucosal malignant melanoma with metastases to submandibular and cervical lymph nodes is described in a four-year-old black girl. Mucosal melanomas are extremely rare in the 1st and 2nd decades, there being only three cases in this age group reported in major published series to date. Origin from a melanocytic naevus is a possibility in this patient in view of the histological features of the primary tumour (AU)