Oral Pemphigoid Masquerading as Necrotizing Ulcerative Gingivitis in a Child

• Autores: Nour J. Musa, Vijay Kumar, Lewis Humphreys, Alfredo Aguirre, Mirdza E. Neiders
• Localización: Journal of periodontology, ISSN 0022-3492, Vol. 73, Nº. 6, 2002, págs. 657-663
• Idioma: inglés
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• Resumen

  • Background: Cicatricial pemphigoid (benign mucous membrane pemphigoid) is an autoimmune vesiculobullous disease that affects mucosal tissues of adults and rarely presents in children. Only 9 cases in the English literature have reported cicatricial pemphigoid in children, primarily as oral mucosal lesions. This paper presents a case of childhood cicatricial pemphigoid that clinically manifested as necrotizing ulcerative gingivitis (NUG).

    Methods: A 9-year-old girl presented with gingival bleeding and discomfort for 2 weeks. NUG was suspected and the patient was treated with antibiotics and an oral hygiene regimen. When the condition did not improve after repeated treatment trials, routine hematoxylin and eosin (H&E) and direct immunofluorescence examinations were performed.

    Results: Microscopic examination of H&E stained sections showed a non-specific ulceration with chronic inflammation. Direct immunofluorescence studies of peri-lesional tissue showed linear deposition of C3 at the basement membrane zone that was consistent with a diagnosis of cicatricial pemphigoid.

    Conclusion: Cicatricial pemphigoid is an autoimmune ulcerative condition that is rarely seen in children. Immunofluorescence studies are essential to differentiate this condition from other ulcerative oral lesions. J Periodontol 2002;73:657-663.