Avaliação das manifestações orais, índice gengival e estado dental nas doenças vesiculobolhosas no ambulatório de dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Resumo (EN)

Vesiculobullous diseases are a complex group of diseases with common clinical characteristics and different pathogenic mechanisms that can affect the skin and mucosae. While their incidence in mucosae may vary, especially in the oral mucosa, the high morbidity associated with vesiculobullous diseases suggests that knowledge of their main characteristics and correlation with dental state and gingival overgrowth is essential in clinical practice. Individuals with vesiculobullous diseases were evaluated to assess their oral manifestations, with emphasis on the identification of the gingival inflammation index, dental status, and therapeutic aspects associated with disease. This is an observational study of a convenience sample, from May 2013 to May 2014, 69 patients who attended the outpatient dermatology clinic of the Hospital das Clínicas, Faculty of Medicine of the University of São Paulo, presenting with vesiculobullous diseases with possible oral lesions were evaluated (pemphigus vulgaris, paraneoplastic pemphigus, mucous membrane pemphigoid, gestational pemphigoid, epidermolysis bullosa acquisita, IgA pemphigus, linear IgA dermatosis, and bullous pemphigoid). Variables such as demographic data, harmful habits, oral manifestations, gingival inflammation index, dental status, location at the beginning of the treatment, pharmacological therapy, and systemic diseases were analyzed statistically by chi-square and Fisher's exact tests. The results demonstrated that the majority of study participants were female (68.7%), with a mean age of 50.8±17 years and White race ethnicity (85.5%). In terms of harmful habits, frequency of use of tobacco, alcohol or illicit drugs was found to be low in the entire cohort. It was observed that 84.1% of the patients had vesiculobullous diseases with oral manifestations that mainly affected the gums (25%). Among the patients with teeth, 93.6% had presented with gingival inflammation and 40.6% had some type of dental prosthesis. Of the patients who started treatment in our institution, only 15.9% had controlled vesiculobullous diseases. Regarding pharmacotherapy, one or more medications were prescribed to 84.1% of the patients, with prednisone (53.7%) being the most frequently used medication. Among patients affected by systemic diseases, musculoskeletal disorders were the most prevalent (52.3%), and 72.5% of the patients received medication. This study concludes that a high incidence of oral lesions was observed in patients with vesiculobullous diseases. The presence of gingival inflammation seems to have a negative effect on the clinical outcome of these diseases. Therefore, further studies should be carried out to better elucidate the correlations of dental and gingival status and vesiculobullous diseases with oral lesions.