Pemphigus vulgaris is a type of autoimmune disease that is characterized by lesions on the skin, as well as on other parts of the body, including inside the mouth. Here are four things you need to know about this disease.
What are the signs of pemphigus vulgaris?
The appearance of lesions inside your mouth is the first sign of this disease in 50% to 70% of patients, and nearly everyone with this disease gets oral lesions at some point. These lesions are irregularly-shaped, slow-healing, and painful. They tend to develop on the insides of the cheeks, on the gums, or on the roof of the mouth. The lesions can also make it hard to eat or drink due to the pain.
The lesions can also spread to nearby areas like the larynx. If this happens to you, your voice may become hoarse. Lesions can also develop on other mucous membranes, like on the inside of your nose.
Pemphigus vulgaris can also lead to skin lesions. These skin lesions look like small, fluid-filled blisters. The blisters rupture and then become painful ulcers. The presence of these skin symptoms can help your dentist identify the cause of your oral lesions.
What causes it?
Researchers still don't know for sure what causes this disease. Genetics may play a role, as certain gene mutations have been found in people with pemphigus vulgaris. It also tends to co-occur with other autoimmune disorders like rheumatoid arthritis or myasthenia gravis, but the reason for this connection still isn't known. The aging process may also play a role somehow, as most people who develop this disease are in their fifties or sixties. More studies are needed to identify which, if any, of these possible factors are responsible.
Is it serious?
Pemphigus vulgaris can lead to serious complications. The lesions inside your mouth may become infected, and when that happens, the infection can spread to your bloodstream. Blood infections, called sepsis, are very serious and can be life-threatening.
The lesions can also make it hard for you to eat and drink, which can lead to vitamin deficiencies. You may feel very tired or lose weight because you're not getting the vitamins you need. Dehydration and electrolyte imbalances are also a concern for people who aren't able to drink without pain.
Pemphigus vulgaris can also make it hard for you to keep up your oral hygiene routine. Brushing, flossing, and rinsing with mouthwash can all be very painful when you have open lesions, so it's easy to let these habits slip. This can lead to problems like cavities, gum disease, and eventually tooth loss.
How can your dentist help?
There are many treatments available to help ease the symptoms of pemphigus vulgaris. You may be given a prescription for oral corticosteroids; these medications work by suppressing your immune system. A high dose is given at first, and once your symptoms have lessened, you'll be switched to a lower dose that is safer for long-term use. You may need to take the corticosteroids indefinitely, but some people are able to stop taking them.
Other medications can also be used. Dapsone, a leprosy medication, can be helpful in keeping your lesions from getting infected. Tetracycline, an antibiotic, can be used for the same purpose. Colchicine, a gout medication, can stop new blisters and lesions from forming.
Your dentist may also recommend home treatments. Switching to a soft-bristled toothbrush can help reduce your irritation and make it easier for you to clean your teeth. Antiseptic mouthwashes may also be recommended to help keep bacteria inside your mouth under control. Tooth decay can make pemphigus vulgaris worse, so it's important that you do as much as you can to look after your teeth.
If you have lesions or blisters inside your mouth, contact a dentist. Once the worst symptoms have been treated, a cosmetic dentistry specialist may be able to help you repair any damage your teeth have experienced from poor care.