Oral Health and Dental Management

Pemphigus vulgaris! Is the body under attack?

28^th Asia Pacific Congress on Dental and Oral Health

July 10-12, 2017 Kuala Lumpur, Malaysia

Farhat Kazmi

Princess Noura Bint Abdurehman University, KSA

Keynote: Oral Health Dent Manag

Abstract:

Background: Pemphigus vulgaris is an autoimmune blistering disease affecting the skin and mucous membranes. It is a potentially life-threatening disease, with mortality rate of 5-15%. The immune system produces antibodies against specific proteins breaking the bonds between cells leading to the formation of blister. About 50% of people with this condition first develop painful blisters and sores in the mouth followed by skin blisters. Case Summary: Twenty-five years old male presented with the complaint of recurrent oral ulcerations and burning sensation while taking salty and spicy food. General Physical examination of patient has showed normal vital with no blisters on the body. Intraoral examination revealed multiple oral ulcerations on labial mucosa, bilateral buccal mucosa extending up to the soft palate. Extraoral examination showed no palpable lymph nodes. Orthopantomogram was advised to rule out any underlying pathology. Nikolsky test was performed which turned out to be positive. X-ray chest was advised to see the status of Hilar lymph nodes which were invisible. Incisional biopsy was taken at multiple oral sites which showed suprabasal clefting with acantholytic changes and spongiosis. Direct immunofluorescence detected immunoglobulin G deposits at the epithelial cell surfaces. Management included counseling of the patient/parents, systemic steroids, required vaccinations, monitoring of blood glucose during the treatment and follow up visits. Systemic steroid (Prednisone) 40 mg/day was advised and was tapered up to 10 mg/day within nine months period. Vaccination for flu and Streptococcus pneumonia was given along with monitoring of blood sugar after every three months. Bisphosphonates were given for bone metabolism. Remarkable improvement was seen within two months period of treatment. Complete remission of disease occurred within nine months period. Conclusion: The systemic steroid is a magical drug to treat life threatening autoimmune diseases.

Biography :

Farhat Kazmi has received her Bachelor of Dental Surgery degree from de’ Montmorency College of Dentistry, Lahore, Pakistan, completed MPhil in Oral Pathology and obtained her PhD in Oral Pathology. She has worked as the Head of Oral Pathology/Diagnostic Department in University College of Dentistry, University of Lahore, Pakistan. Currently, she is working as an Associate Professor in College of Dentistry, Princess Noura Bint Abdurehman University, Riyadh, Saudi Arabia. She has published more than 20 papers in reputed journals.

Email: drfarhatkazmi@gmail.com