Penfigoide cicatricial: relato de caso

Abstract

The benign mucomembranous pemphigoid is a type of vesiculobullous, chronic, autoimmune lesion in which autoantibodies are produced against one or more components of the basal membrane, and can generate as a consequence several cutaneous mucus manifestations such as: bubbles in the oral mucosa, ulcerations, descamative gingivitis, and the symphysis (healing between the conjunctival /ocular mucosa and the eyelid) that can lead to blindness. The objective of this work was to report a clinical case of a 47-year-old woman, a leukoderma, with the complaint of painful wounds in her mouth that appeared and disappeared spontaneously. After anamnesis, the intraoral examination revealed an aspect of gingivitis, showed a sign of positive Nikolsky, from this and the oral conditions of the patient the diagnostic hypotheses suggested were bullous pemphigus or scarring pemphigoid. A perilesional incisional biopsy was performed, the histopathological examination revealed area of detachment of the epithelium, subepithelial cleft, hyperplasia of the epithelial tissue, keratinized epithelium, fibrous connective tissue with inflammatory infiltrate composed of neutrophils, plasmocytes, eosinophils, and lymphocytes, and vascularized areas, being compatible with scar pemphigoid. After the diagnosis, the protocol established was the cheek with solution based on clobetasol propionate, nystatin and distilled water, after 15 days of treatment with topical corticoid significant improvement was observed. The patient was followed every week until the remission of the lesions and is in progress with the clinical picture controlled.