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Oral mucous membrane pemphigoid: updates in diagnosis and management

British Dental Journal volume 236, pages 293–296 (2024)Cite this article

Abstract

Mucous membrane pemphigoid (MMP) is a rare, immune-mediated, vesiculobullous disease that predominantly affects the oral cavity and conjunctiva. In MMP, autoantibodies are directed against hemidesmosomal proteins in the basement membrane zone, most commonly BP180. Clinical signs and symptoms include gingival desquamation, erosions, and ulcerations. Differential diagnoses include other immune-mediated blistering diseases, such as bullous pemphigoid. Definitive diagnosis is reached through history taking, physical examination, tissue biopsy and/or serology testing. MMP, although not curable, is typically managed with topical or systemic corticosteroids, in addition to immunosuppressive therapies and biologic agents in recalcitrant cases. Untreated MMP can lead to life-threatening complications, such as blindness. As a condition that affects the oral cavity, it is important that dentists understand how to recognise, diagnose and manage the disease.

Key points

  • Mucous membrane pemphigoid (MMP) is a rare, vesiculobullous disease that can manifest as ulcerations, erosions, blisters, or desquamation of tissue. Thorough clinical examination is key during appointments.

  • Patients with MMP may manifest with extra-oral signs, such as eye and skin involvement. A thorough review of systems in office can help differentiate MMP from other conditions.

  • In practice, general dentistry providers may recommend avoidance of trauma to the tissue in order to reduce the risk of ulceration or blister formation.

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Authors and Affiliations

  1. Assistant Professor of Oral Medicine, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA

    Roopali Kulkarni

  2. Professor of Oral Medicine, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA

    Eric T. Stoopler

  3. Professor and Chair of Oral Medicine, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA

    Thomas P. Sollecito

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  1. Roopali Kulkarni
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  2. Eric T. Stoopler
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  3. Thomas P. Sollecito
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Contributions

Roopali Kulkarni: writing and editing. Eric T. Stoopler: editing. Thomas P. Sollecito: editing and supervision.

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Correspondence to Thomas P. Sollecito.

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The authors declare no conflicts of interest.

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Kulkarni, R., T. Stoopler, E. & P. Sollecito, T. Oral mucous membrane pemphigoid: updates in diagnosis and management. Br Dent J 236, 293–296 (2024). https://doi.org/10.1038/s41415-024-7064-x

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