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 2010 to July 2011. Patients with confirmed pemphigus and pemphigoid skin disease were selected and informed to participate in the study. Oral examination of all participants were done to document site and type of oral manifestation and diagnostic procedures such as histopathological and Immunofluorescence methods were performed to confirm the diagnosis. Demographic details such as age, gender and occupation were also documented. The results of the study were analyzed by SPSS software version 19.0 (Armonk, NY) and presented as descriptive statistics. Results: Sixty percent of the patients exhibited oral mucosal manifestations. A higher female (86.66%) predilection of autoimmune blistering disease was observed in the study. A slightly higher number of pemphigoid patients (53.33%, 16 out of 30) were reported than pemphigus (46.66%, 14 out of 30 cases). The most common subtypes of pemphigus is Pemphigus vulgaris 71% (10 out of 14) among pemphigus, and bullous pemphigoid 87.5%(14 out of 16) among pemphigoid. Buccal mucosa (92.85%) is the most common site in pemphigus patients, where as hard palate (12.5%) is mostly commonly reported site in pemphigoid patients. Initial involvement of oral tissue in disease process was observed in 78.57% of pemphigus, and 12.5% of pemphigoid patients. Conclusion: Oral mucosal lesions are more frequently associated in pemphigus patients. Oral mucosal lesions are the initial site of disease process in pemphigus patients. The significance of diagnosis of oral lesions at earlier stage of disease, specifically pemphigus may help in early intervention of disease and help to reduce the morbidity and mortality state. The study emphasizes multidisciplinary approach in diagnosis and management of both pemphigus and pemphigoid.