Pemphigus vulgaris is a potentially fatal mucocutaneous, vesiculobullous disorder of autoimmune etiology. Regrettably, affected patients frequently experience considerable discomfort and diagnostic delay for months in spite of multiple clinician contacts. The high likelihood of disease manifestations in the oral cavity and serious nature of potential oral and systemic complications mandates dental professionals to recognize early oral signs and symptoms of pemphigus vulgaris and contribute to timely diagnosis and medical intervention to prevent disease progression. This case report presents a young man with pemphigus vulgaris whose oral disease caused him significant suffering and spread to the skin before he was finally diagnosed 3 months after the onset. The signs and symptoms of the disease are reviewed and the potential role of dental providers in timely recognition and management is emphasized.
[Show abstract][Hide abstract] ABSTRACT: Introduction:
Pemphigus vulgaris is a relatively rare, chronic, autoimmune vesiculobullous disorder characterized by formation of intraepithelial vesiculae and/or bullae in the skin and mucous membrane. Systemic steroids are considered to be the standard first-line therapy for pemphigus vulgaris. However, for patients unresponsive to standard therapy, the new treatment modalities are being sought. Low-level laser therapy has been accepted as an alternative or adjunctive treatment modality for many conditions in medicine and dentistry. Therefore, this study was aimed at presenting the effects of low-level laser therapy in the treatment of pemphigus vulgaris and to emphasize the crucial role of dentists in early recognition and diagnosis of pemphigus vulgaris.
Material and methods:
The articles published until May 2013 were obtained from the Medline/PubMed online database, using following search terms and key words: "laser therapy" and "pemphigus vulgaris", "low-level laser irradiation" and "pemphigus vulgaris", "lasers" and "pemphigus vulgaris" and "pemphigus vulgaris".
Low-level laser therapy could result in immediate and significant analgesia and improved wound healing within the observation period and follow-up. Furthermore, a decrease in patients' discomfort as well as the absence of recurrence of the pemphigus vulgaris lesions has been claimed.
Even though available literature suggests that low-level laser therapy can be efficiently used in treatment of oral pemphigus vulgaris, either independently or as a part of combined therapy approach, these results should be interpreted with caution since there are no solid evidence-based proofs to provide the guidelines for the treatment of pemphigus vulgaris with low-level laser therapy. Therefore, further long-term randomized controlled clinical studies are necessary in order to give any solid recommendations on the use of low-level laser therapy in the treatment of pemphigus vulgaris.
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