Abstract

Background: The study aimed to assess the different manifestations of MMP among patients diagnosed as MMP.

Methodology: The study was conducted as a cross sectional study at PMCH, Patna for a period of 3 years on 30 patients diagnosed as a case of MMP in the departments of Otorhinolaryngology, dermatology and ophthalmology. Detailed history regarding clinical features, mode of presentation, and duration of symptoms was obtained and entered in questionnaire. Statistical analysis- Data was compiled using Ms Excel and analysed using IBM SPSS 20. Categorical data was expressed as frequency and percentage.

Results: Majority of patients with MMP belonged to 61 to 80 years of age (83.3%) and majority of cases were females. The most common site of involvement was oral mucosa (96.7%), followed by ocular conjunctiva in 63.3% and laryngeal mucosa (46.7%). About 55.8% patients with oral lesions presented with oral ulceration and about 47.4% cases with ocular lesions presented with non-specific conjunctivitis. In cases with laryngeal involvement, 28.6% cases presented with laryngeal stenosis with breathing difficulty. Nasal mucosal erosions, localized erythematous plaque, dysphagia and odynophagia were predominant manifestations in cases with nasal, skin, pharynx and oesophageal involvement respectively.

Conclusion: Mucous membrane pemphigoid is a rare disorder which most commonly involve oral mucosa. However, ocular, nasopharynx, larynx, oesophagus involvement can also be observed. Depending upon site of involvement, patients may present with varied manifestations such as oral erosions and ulcers, desquamative gingivitis in case of oral lesions, cicatrizing conjunctivitis in case of ocular involvement.

Keywords: Mucous Membrane Pemphigoid; Oral; Ocular; Pseudo Membrane; Airway

References

1. Chan LS., et al. “The first international consensus on mucous membrane pemphigoid: definition, diagnostic criteria, pathogenic factors, medical treatment, and prognostic indicators”. Archives of Dermatological Research 138 (2002): 370-379.
2. Schmidt E and Zillikens D. “Pemphigoid diseases”. Lancet 381 (2013): 320-332.
3. Thorne JE., et al. “Mucous membrane pemphigoid and pseudopemphigoid”. Ophthalmology 111 (2004): 45-52.
4. Lawson WM. “Bullous oral erosions: clues to identifying-and managing-the cause”. Consultant11 (1998): 2657-2666.
5. Radford CF., et al. “Incidence, presenting features, and diagnosis of cicatrizing conjunctivitis in the United Kingdom”. Eye 9 (2012): 1199.
6. Bertram F., et al. “Prospective analysis of the incidence of autoimmune bullous disorders in Lower Franconia, Germany”. JDDG: Journal der Deutschen Dermatologischen Gesellschaft 5 (2009): 434-439.
7. Cohen SJ., et al. “Cutaneous manifestations of cryoglobulinemia: clinical and histopathologic study of seventy-two patients”. Journal of the American Academy of Dermatology1 (1991): 21-27.
8. Kamaguchi M and Iwata H. “The Diagnosis and Blistering Mechanisms of Mucous Membrane Pemphigoid”. Frontiers in Immunology 10 (2019): 34.
9. Dharman S and Muthukrishnan A. “Oral mucous membrane pemphigoid - Two case reports with varied clinical presentation”. Journal of Indian Society of Periodontology 6 (2016): 630-634.
10. Chiou S., et al. “Mucous membrane pemphigoid: a retrospective study”. Journal - Michigan Dental Association 5 (2007): 46-52.
11. Silverman S., et al. “Oral mucous membrane pemphigoid. A study of sixty-five patients”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 61 (1986): 233-237.
12. Agbo-Godeau S., et al. “Cicatricial pemphigoid: Management in stomatology”. Revue de Stomatologie et de Chirurgie Maxillo-Faciale 105 (2004): 206-210.
13. Higgins GT., et al. “Development of ocular disease in patients with mucous membrane pemphigoid involving the oral mucosa”. British Journal of Ophthalmology 8 (2006): 964-967.
14. Georgoudis P., et al. “Ocular Mucous Membrane Pemphigoid: Current State of Pathophysiology, Diagnostics and Treatment”. Ophthalmology and Therapy 1 (2019): 5-17.
15. Madgar O., et al. “Mucous membrane pemphigoid-otorhinolaryngological manifestations: a retrospective cohort study”. European Archives of Oto-Rhino-Laryngology 3 (2020): 939-945.
16. Lambiel S., et al. “Paraneoplastic mucous membrane pemphigoid with ocular and laryngeal involvement”. BMJ Case Report (2017): bcr2017220887.

Citation

Citation: Baban Kumar. “Mucous Membrane Pemphigoid with Different Manifestations- A Cross Sectional Study"..Acta Scientific Otolaryngology 3.6 (2020): 40-43.

Copyright

Copyright: © 2020 Baban Kumar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.