GINGIVAL INVOLVEMENT IN MUCOUS-MEMBRANE PEMPHIGOID

A 60-year-old woman with clinical features of desquamative gingivitis had a history of painful, blistering gingival lesions for more than 2 years. There were no other accompanying mucosal or skin lesions. Clini cal examination revealed erythematous and edematous gingiva with ulcer ated areas and evidence of intact and ruptured bullae. White plaquelik e lesions were also noted. Gingival manipulation caused epithelial des quamation. Light microscopic examination of biopsy specimens from the perilesional gingival tissue showed separation of the oral gingival ep ithelium and connective tissue at the margin of the collapsed bulla. A moderately intense inflammatory infiltrate was present in the connect ive tissue. Direct immunofluorescent microscopy revealed a continuous linear deposition of immunoglobulin G and C3 at the basement membrane zone. On the basis of clinical, histopathologic, and immunofluorescent findings, the diagnosis of mucous membrane pemphigold was made.