European Journal Pharmaceutical and Medical Research
Bullous pemphigoid masquerading as desquamative gingivitis in two elderly patients: A rare case report
By 1*Dr. Manali Shashikant Waghmare, 2Dr. Smita Malbhage, 3Dr. Yadnya Shashikant Waghmare, 4Dr. Gurudev Swami.
Abstract
Background
Bullous pemphigoid (BP) is a chronic autoimmune subepithelial blistering disease of older adults that only uncommonly involves the oral mucosa, where it may mimic ordinary periodontal disease. Case Presentation: Two elderly patients presented with painful desquamative gingivitis (DG). A 65-year-old woman had 6 months of oral burning unresponsive to routine care, with an intact tense bulla at the maxillary left canine (tooth 23); biopsy confirmed BP, and corticosteroids produced marked improvement within 3 weeks. A 72-year-old man on multiple medications, with psychological stress and tobacco use, showed gingival changes consistent with DG.
Discussion
The differential diagnosis of DG includes mucous membrane pemphigoid, BP, pemphigus vulgaris, and erosive lichen planus; these overlap clinically, so perilesional biopsy with direct immunofluorescence is essential.