2017 Volume 59 Issue 4 Pages 230-240
As pemphigus vulgaris can cause exfoliation of the gingival epithelium as one of its symptoms, tooth brushing and eating can be painful, leading to a decreased quality of life. Pemphigus vulgaris can relapse even after the lesions have healed, and careful attention should be paid not only to the intraoral conditions, but also to the systemic and mental conditions of the patient at the time of periodic dental examinations. We report the case of a 41-year-old woman who complained of redness, swelling, and gingival pain. She was treated for a suspected necrotizing ulcerative periodontal disease by a family dental office, but her symptoms did not improve. Thus, she was referred to our department. In our hospital's Department of Dermatology, she was diagnosed as having pemphigus vulgaris based on the results of blood tests and a histopathological examination of the gingiva and skin tissues. She was hospitalized in the Department of Dermatology and treated with prednisolone, a corticosteroid. During hospitalization, thorough oral hygiene instructions and professional tooth cleaning focusing on the sites where the patient had difficulty cleaning her teeth were provided, and mental support and guidance regarding eating habits and meals that might exacerbate her condition were conducted by a dental hygienist once a week. The patient's oral symptoms were gradually ameliorated, and we modified her oral cleaning tools and self-care method based on her gingival condition. After discharge, a recurrence of epithelial exfoliation in part of the gingiva was observed during the supportive periodontal therapy period, and her self-care method was once again reconsidered. Since pemphigus vulgaris can exhibit a relapse of symptoms, it is important for dental staff, including dental hygienists and dentists, to notice abnormalities in the gingival conditions of patients as early as possible and to cooperate with medical staff to support patients so that the patients can live their daily lives with ease.
