USE OF OCCLUSIVE TOPICAL CORTICOSTEROIDS IN THE TREATMENT OF PEMPHIGOID SCARRING OF MUCOUS MEMBRANES IN A PATIENT WITH GINGIVITIS SCALY

Abstract

Pemphigoid of the mucous membranes is an autoimmune, vesiculobullous, chronic disease characterized by the presence of suprabasal or subepithelial blisters on mucous membranes. It predominantly affects a fixed older age, generally from the fourth decade of life. Ocular involvement is common, with the formation of scars characteristic of this type of pemphigoid, and when the conjunctiva is affected, it can lead the patient to blindness. Those with this alteration may have involvement of the oral mucous membranes, with the inserted gingiva being the most affected site, triggering a condition of desquamative gingivitis, as well as painful and bleeding bullous lesions with deep cleavage. The etiology is unknown, but some authors associate pemphigoid with the use of certain drugs such as Captopril, Furosemide and Amoxicillin. Diagnosis is based on clinical history, perilesional biopsy and direct immunofluorescence. Histopathological examinations show the separation of the basal epithelial layer from the connective tissue itself, vacuolation in the basal lamina under an intact epithelium, and deposits of IgG and C3 in the basal membrane, which can be identified through direct immunofluorescence. The treatment is done in a multidisciplinary way, through topical or systemic corticosteroid therapy, depending on the severity of the disease, in addition to laser therapy and drug associations. The present work aims to present a case of pemphigoid of the mucous membranes, where the patient presented lesions in the eyes and in the oral mucosa, with a diagnosis confirmed through histopathology, in concomitant treatment of stomatology with other medical specialties, such as ophthalmology, presenting satisfactory evolution of the mouth injuries.