Evaluation of the Frequency of Pemphigoid and Its Mucosal Manifestations in Patients with Immunobullous Lesions Referring to Isfahan Dental School and Alzahra Hospital Over an 8-Year Period from 2008 to 2016

Document Type : مقاله‌های پژوهشی

Authors

1 Professor, Dental Research Center, Department of Oral & Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Dental Research Center, Department of Oral & Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran

3 Dental Student, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran

4 Ophthalmologist, Isfahan, Iran

10.48305/v0i0.1549

Abstract

Introduction: Cicatricial pemphigoid is a type of immunobullous disease. A number of ocular manifestations can occur in these patients. Early diagnosis can be effective in preventing ocular complications. This study investigated the frequency of pemphigoid and its mucosal manifestations in patients with immunobullous lesions referring to Isfahan Dental School and Alzahra Hospital over 8 years.
Materials and Methods: In this cross-sectional descriptive/analytical study, 127 patient files of pemphigoid disease were evaluated in the Archives of the Department of Oral Diseases in Isfahan Dental School and Alzahra Hospital. The data on the age and sex of the patients were recorded. The patients were recalled and questioned about the location of the oral, cutaneous and ocular lesions, the treatment of these lesions, and the time of recovery of the lesions. All the relevant data were provided as a checklist and analyzed with SPSS 22, using ANOVA and descriptive statistical methods, including frequency distribution tables, calculation of percentages and relationships, and use of circular and bar diagrams (α = 0.05).
Results: The mean age of the patients was 64 years. There was a female predilection (2:1). Eye symptoms were more frequent in patients < 60 years of age, and ocular manifestations in patients with oral manifestations were four folds more frequent compared to patients without oral manifestations.
Conclusion: The frequency of the pemphigoid disease was 18.814%. The frequency of ocular involvement in these patients was 12.3%, with blurred vision (4.1%) being the most common problem. The relationships between ocular and oral involvement, ocular and cutaneous involvement, and the ocular involvement and age and sex were not significant.
Key words: Autoimmune diseases, Bullous pemphigoid, Benign mucosal pemphigoid, Eye manifestations, Pemphigus

References

1. Tan JC, Tat LT, Francis KB, Mendoza CG, Murrell DF, Coroneo MT. Prospective study of ocular manifestations of pemphigus and bullous pemphigoid identifies a high prevalence of dry eye syndrome. Cornea 2015; 34(4): 443-8.
2. Higgins GT, Allan RB, Hall R, Field EA, Kaye SB. Development of ocular disease in patients with mucous membrane pemphigoid involving the oral mucosa. Br J Ophthalmol 2006; 90(8): 964-7.
3. Marazza G, Pham HC, Schärer L, Pedrazzetti PP, Hunziker T, Trüeb RM, et al. Incidence of bullous pemphigoid and pemphigus in Switzerland: a 2‐year prospective study. Br J Dermatol 2009; 161(4): 861-8.
4. Neville BW, Damm DD, Chi AC, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th. Philadelphia, PA: Elsevier Health Sciences; 2015 .p. 722.
5. Broussard KC, Leung TG, Moradi A, Thorne JE, Fine JD. Autoimmune bullous diseases with skin and eye involvement: cicatricial pemphigoid, pemphigus vulgaris, and pemphigus paraneoplastica. Clin Dermatol 2016; 34(2): 205-13.
6. Elder MJ, Dart JK, Collin R. Inferior retractor plication surgery for lower lid entropion with trichiasis in ocular cicatricial pemphigoid. Br J Ophthalmol 1995; 79(11): 1003-6.
7. Fernando SL, Myers P. Turning a blind eye: ocular mucous membrane pemphigoid. BMJ Case Rep 2009: 2009: 1584.
8. Daneshpazhooh M, Khorassani J, Balighi K, Ghandi N, Mahmoudi H, Tohidinik H, et al. Neurological diseases and bullous pemphigoid: A case–control study in Iranian patients. Indian J Dermatol Venereol Leprol 2017; 83(2): 195-9.
9. Kershenovich R, Hodak E, Mimouni D. Diagnosis and classification of pemphigus and bullous pemphigoid. Autoimmun Rev 2014; 13(4-5): 477-81.
10. Daneshpazhooh M, Chams-Davatchi C, Payandemehr P, Nassiri S, Valikhani M, et al. Spectrum of autoimmune bullous diseases in Iran: a 10‐year review. Int J Dermatol 2012; 51(1): 35-41.
11. Bertram F, Bröcker EB, Zillikens D, Schmidt E. Prospective analysis of the incidence of autoimmune bullous disorders in Lower Franconia, Germany. J Dtsch Dermatol Ges 2009; 7(5): 434-40.
12. Esmaili N, Hallaji Z, Soori T, Davatchi C. Bullous pemphigoid in Iranian patients: a descriptive study on 122 cases. Acta Med Iran 2012; 50(5): 335-8.
13. Banihashemi M, Zabolinejad N, Vahabi S, Razavi HS. Survey of bullous pemphigoid disease in northern Iran. Int J Dermatol 2015; 54(11): 1246-9.
14. Schmidt E, Zillikens D. Pemphigoid diseases. Lancet 2013; 381(9863): 320-32.
15. Thorne JE, Anhalt GJ, Jabs DA. Mucous membrane pemphigoid and pseudopemphigoid. Ophthalmology 2004; 111(1): 45-52.
16. Ong HS, Setterfield JF, Minassian DC, Dart JK, Mucous Membrane Pemphigoid Study Group 2009-2014. Mucous membrane pemphigoid with ocular involvement: the clinical phenotype and its relationship to direct immunofluorescence findings. Ophthalmology 2018; 125(4): 496-504.
17. Szabo E, Palos M, Skalicka P. [Ocular Cicatricial Pemphigoid - a Retrospective Study]. Cesk Slov Oftalmol 2016; 72(1): 283-92.
18. Goldich Y, Ziai S, Artornsombudh P, Avni-Zauberman N, Elbaz U, Rootman DS, et al. Characteristics of patients with ocular cicatricial pemphigoid referred to major tertiary hospital. Can J Ophthalmol 2015; 50(2): 137-42.
19. Langan S, Smeeth L, Hubbard R, Fleming K, Smith C, West J. Bullous pemphigoid and pemphigus vulgaris--incidence and mortality in the UK: population based cohort study. BMJ 2008; 337: a180.

Files

Share

How to cite

Statistics