Oral Lesions in Patients with Pemphigus Vulgaris and Bullous Pemphigoid

Ova studija obuhvatila je 33 bolesnika hospitaliziranih u Klinici za kožne i spolne bolesti Kliničke bolnice "Sestre milosrdnice". Svrha ove studije bila je usporedba podataka o dobi i spolu, navikama, lokalizaciji kožnih promjena, pojavi simptoma i terapiji u bolesnika s vulgarnim pemfigusom i onih koji boluju od buloznog pemfigoida. Dijagnosticirano je 15 bolesnika s vulgarnim pemfigusom i 18 bolesnika s buloznim pemfigoidom temeljeno na kliničkoj slici, patohistološkoj analizi, direktnoj i indirektnoj imunofluorescenciji, Tzanckovom testu i dezmogleinima. Dobiveni rezultati upućuju na porast učestalosti vulgarnog pemfigusa u bolesnika srednje dobi (46,6% bolesnika između 50 i 70 godina), dok bulozni pemfigoid zahvaća bolesnike starije životne dobi (83,3% bolesnika bilo je starije od 70 godina). Vulgarni pemfigus zahvaća značajnije više žene (66,6%) nego muškarce (33,4%), dok je jednak broj žena i muškaraca bio zahvaćen buloznim pemfigoidom. Bolesnici s objema bolestima su imali promjene kože i/ili sluznice usne šupljine. Većina bolesnika s vulgarnim pemfigusom je imala promjene kože s promjenama na sluznici usne šupljine (86,6%), pri čemu su u 40% slučajeva promjene na sluznici usne šupljine prethodile kožnim promjenama. U samo 16,6% bolesnika s buloznim pemfigoidom su nađene erozije na sluznici usne šupljine. Većina bolesnika je dobivala sistemsku i lokalnu kortikosteroidnu terapiju uz dodatnu sistemsku imunosuprimirajuću terapiju. Pravodobno prepoznavanje vulgarnog pemfigusa i buloznog pemfigoida te odgovarajuća terapija važni su za ishod ovih autoimunih buloznih bolesti.Thirty three patients admitted to the University Department of Dermatology and Venereology, Sestre milosrdnice University Hospital, were included in the study. The purpose of the study was to compare data on age and gender, habits, lesion localization, onset of symptoms and therapy between patients with pemphigus vulgaris and those suffering from bullous pemphigoid. Based on clinical presentation, histopathologic analysis, direct and indirect immunofluorescence, Tzanck smear and desmogleins, 15 cases of pemphigus vulgaris and 18 cases of bullous pemphigoid were diagnosed. The results obtained indicated an increased prevalence of pemphigus vulgaris in middle-aged patients (46.6% of patients were aged between 50 and 70), while bullous pemphigoid predominantly affected elderly individuals (83.3% of patients were older than 70). Pemphigus vulgaris showed a female predominance (female 66.6% vs. male 33.4%), while no sex difference was recorded for bullous pemphigoid. Patients with both diseases presented with cutaneous and/or oral lesions. The majority of patients with pemphigus vulgaris had skin lesions with oral manifestations (86.6%), whereas in 40% of cases oral lesions were preceded by the cutaneous ones. Mucosal erosions were found in only 16.6% of patients with bullous pemphigoid. The majority of patients were administered systemic and topical corticosteroid therapy with adjuvant systemic immunosuppressant therapy. Timely recognition of pemphigus vulgaris and bullous pemphigoid and appropriate treatment are important for the prognosis of these autoimmune bullous disorders