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Mucous membrane pemphigoid - a report of four cases

Introduction. Mucous membrane pemphigoid (MMP) is a rare autoimmune, chronic
 inflammatory disease which affects mucous membranes, most commonly the eyes
 and 3 mouth, with or without skin involvement. It is a complex disease
 with several complications including scarring, especially on conjunctival
 mucosa that can lead to visual loss. Case report. We report four patients
 (two men and two women) with MMP. In all patients the disease started in
 their seventies. The diagnosis was confirmed on the basis of clinical
 appearance, histology, direct and indirect immunofluorescence studies,
 indirect split skin technique and ELISA test. The majority of lesions were
 on the gums and buccal mucosa, one patient had laryngeal involvement and a
 lesion on the umbilicus. No ocular involvement and no malignancy were
 detected. Direct immunofluorescence tests revealed continuous linear IgG
 deposition in the basal membrane zone in two patients, and they were treated
 with oral nicotinamide and tetracycline hydrochloride. In two patients we
 detected IgG along with IgA linear deposition; they received treatement with
 methylprednisolone. Complete remission was achieved in all patients.
 Conclusion. Early diagnosis as well as a multidisciplinary therapeutic
 approach is necessary for the MMP treatment in long term disease control and
 reduction of the disease-related complications.