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    Revista Odonto Ciência (Online)

      ISSN 1980-6523

    Rev. odonto ciênc. (Online) vol.25 no.1 Porto Alegre ene. 2010

     

    CASE REPORT

     

    Management of mucous membrane pemphigoid with dapsone plus weekly steroid injections in a young patient: a case report

     

    Tratamento de penfigóide membranoso mucoso com dapsona e injeções semanais de esteróide em um paciente jovem: relato de caso

     

     

    Gurumoorthy KaarthikeyanI; N.D. JayakumarI; Ogoti PadmalathaI; Joseph M. ThachilI; Sheeja VargheseI; Thiruvengadam ChandrasekarII

    IDepartment of Periodontics, Saveetha Dental College and Hospitals, Chennai-77, India
    IIDepartment of Oral Pathology, Saveetha Dental College and Hospitals, Chennai-77, India

    Correspondence

     

     


    ABSTRACT

    PURPOSE: Mucous Membrane Pemphigoid (MMP) is an autoimmune subepithelial blistering disorder usually affecting older individuals. This paper describes the pharmacological management of MMP in a young patient.
    CASE DESCRIPTION: A 23 year-old woman showed erythematous ulcerative gingiva in the maxillary palatal region and around the retromolar region. A perilesional excisional biopsy was done, and the histologic and immunohistochemical analysis confirmed the clinical diagnosis of MMP as the cause of desquamative gingivitis in this patient. The patient was treated with topical steroids plus daily Dapsone 100 mg and weekly steroid injections (40 mg). The lesions began to resolve after 12 weeks of therapy.
    CONCLUSION: This case of MMP in a young female patient was effectively managed with a combination therapy of topical steroids, Dapsone and steroid injections.

    Key words: Pemphigoid; topical steroids; dapsone; steroid injections; immunofluorescence


    RESUMO

    OBJETIVO: O penfigóide membranoso mucoso (PMM) é uma desordem autoimume subeptelial bolhosa que geralmente afeta indivíduos mais velhos. Este relato de caso descreve a abordagem farmacológica do PMM em uma paciente jovem.
    DESCRIÇÃO DO CASO: Uma paciente do sexo feminino, com 23 anos de idade, apresentava a gengiva eritematosa e ulcerada na região palatina e na região retromolar. A biópsia excisional total foi realizada e as análises histológica e de imuno-histoquímica confirmaram o diagnóstico clínico de PMM como causa da gengivite descamativa nesta paciente. A paciente foi tratada com esteróides tópicos, Dapsona 100 mg diariamente e injeções de esteróides mensais (40 mg). A resolução das lesões se iniciou após 12 semanas de terapia medicamentosa.
    CONCLUSÃO: Este caso de PMM em uma paciente jovem foi efetivamente tratado com uma terapia combinada de esteróides tópicos, Dapsona e injeções de esteróides.

    Palavras-chave: Penfigóide membranoso mucoso; esteróides tópicos; dapsona; injeções de esteróide; imunofluorescência


     

     

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    Full text available only in PDF format.

     

     

    References

    1. Borradori L, Bernard P. Vesiculobullous diseases: pemphoid group. In: Bolognia JL, Jorizzo JL, Rapini RP, editors. Dermatology. Philadelphia: Mosby/Elsevier; 2004. p. 463-70.         [ Links ]

    2. Chan LS, Ahmed AR, Anhalt GJ, Bernauer W, Cooper KD, Elder MJ et al. The first international consensus on mucous membrane pemphigoid: definition, diagnostic criteria, pathogenic factors, medical treatment, and prognostic indicators. Arch Dermatol 2002;138:370-9.         [ Links ]

    3. Person JR, Rogers RS III. Bullous and cicatricial pemphigoid. Clinical, histopathologic, and immunopathologic correlations. Mayo Clin Proc 1977;52:54-66.         [ Links ]

    4. Chan LS. Mucous membrane pemphigoid. Clin Dermatol 2001; 19:703-11.         [ Links ]

    5. Yih WY, Maier T, Kratochvil F J, Zieper MB. Analysis of desquamative gingivitis using direct immunofluorescence in conjunction with histology . J Periodontol 1998;69:678-85.         [ Links ]

    6. Carbone M, Carrozzo M, Castellano S, Conrotto D, Broccoletti R, Gandolfo S. Systemic corticosteroid therapy of oral vesiculoerosive diseases (OVED). An open trial. Minerva Stomatol 1998;47:479-87.         [ Links ]

    7. Rzany B, Partscht K, Jung M; et al. Risk factors for lethal outcome in patients with bullous phemphigoid: low serum albumin level, high dosage of glucocorticosteroids, and old age. Arch Dermatol 2002;138:903-8.         [ Links ]

    8. Joly P, Roujeau JC, Benichou J, Picard C, Dreno B, Delaporte E, et al. A comparison of oral and topical corticosteroids in patients with bullous pemphigoid. N Engl J Med 2002;346:321-7.         [ Links ]

     

     

    Correspondence:
    G. Kaarthikeyan

    Department of Periodontics
    Saveetha Dental College & Hospitals
    162, P.H Road, Velappanchavadi
    Chennai - India 600077
    Email: drkarthik79@yahoo.co.in

    Received: October 3, 2009
    Accepted: November 16, 2009