Mucous membrane pemphigoid-a report of four cases

Introduction. Mucous membrane pemphigoid (MMP) is a ra-re autoimmune, chronic inflammatory disease that affects mu-cous membranes, most commonly the eyes and 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 pa-tients, the disease started between seventy and eighty years of age. The diagnosis was confirmed based on clinical appearance, histology, direct and indirect immunofluorescence studies, indi-rect split skin technique, and enzyme-linked immunosorbent assay (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 ma-lignancy were detected. Direct immunofluorescence tests re-vealed continuous linear IgG deposition in the basal membrane zone in two patients, and they were treated with oral nicotina-mide and tetracycline hydrochloride. In two patients, we de-tected IgG along with IgA linear deposition; they received treatment with methylprednisolone. Complete remission was achieved in all patients. Conclusion. Early diagnosis and an adequate therapeutic approach are necessary for the MMP treatment in long-term disease control and reduction of dis-ease-related complications.