Immunopathological diagnosis of cicatricial pemphigoid with desquamative gingivitis. A case report

Cicatricial pemphigoid (CP) is a chronic subepidermal bullous dermatosis wh ich primarily involves the mucous membranes. The oral cavity and the eye ar e most frequently involved. Since extension of the lesion into the pharynx and esophagus causes sore throat and dysphagia and progressive ocular lesio ns may cause blindness, early and valid diagnosis is very important. Here w e present a case of cicatricial pemphigoid with onset at age 45 in a patien t who manifested severe periodontal disease and showed the lesion on the mu cous membranes of the mouth (desquamative gingivitis), skin, and eyes. Sinc e definite diagnosis is very important, we describe how we made a different ial diagnosis from other diseases which also accompany desquamative gingivi tis. We examined the clinical manifestations, blood test results, HLA-genot ype, histopathologic findings of the affected tissue, and immunological fin dings in relation to autoimmunity. Since many of the CP cases are first ref erred to periodontists or dentists, we believe that the diagnostic strategy described in the present study will be quite informative for making rapid and definite diagnoses of similar cases.