Abstract
Pemphigus vulgaris is an autoimmune disease that forms intraepithelial blisters on the skin and mucous membranes, including the oral mucosa and gingiva. In this paper, we report a case in which nonsurgical periodontal therapy was successfully applied for the treatment of periodontitis with pemphigus vulgaris exhibiting severe edematous swelling and desquamative erosion. A 56-year-old woman visited our hospital because of gingival swelling and bleeding during brushing. She suffered from pemphigus vulgaris and had routinely visited a dermatologist since her 30s, but had not routinely visited a dentist. At her initial visit,edematous swelling and desquamative erosion were observed in the oral mucosa and gingiva. A probing pocket depth of over 4 mm was observed at 79.7% of the sites, and large quantities of plaque and calculus were deposited on the teeth because of insufficient brushing as a result of pain. Moderate bone resorption was confirmed using an X-ray photograph. First, we provided oral hygiene instructions with careful attention to her oral symptoms. Since her periodontal condition improved in parallel with her self-improvement in plaque control, we performed scaling/root planning and treatment for the recovery of occlusal function. At present, edematous swelling and desquamative erosion are not observed, and her oral condition has been well maintained. The presence of plaque is considered to be a key modulator aggravating the oral symptoms of pemphigus vulgaris, and careful oral hygiene instruction tailored to a patientʼs clinical symptoms is important for periodontal treatment in patients with pemphigus vulgaris. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 56(4)：451-456, 2014.
