Mucous membrane pemphigoid

Published on 19/03/2015 by admin

Filed under Dermatology

Last modified 19/03/2015

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Mucous membrane pemphigoid

Caroline P. Allen and Vanessa Venning

Evidence Levels:  A Double-blind study  B Clinical trial ≥ 20 subjects  C Clinical trial < 20 subjects  D Series ≥ 5 subjects  E Anecdotal case reports

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Mucous membrane pemphigoid (MMP) formerly known as cicatricial pemphigoid is a heterogeneous group of chronic acquired autoimmune sub-epidermal blistering diseases. It is characterized by blistering and erosions of one or more mucous membranes (eyes, oral mucosa, oesophagus, genitals) and to a lesser extent the skin. This may lead to permanent scarring of the affected area, particularly the conjunctiva.

Management strategy

MMP is a chronic disease and does not generally remit spontaneously; disease activity will fluctuate without treatment, and treatments are disease modifying rather than curative.

Optimal treatment for MMP is unclear as there is little evidence in the form of randomized control trials; international consensus guides treatment strategy, based on the site, severity, extent and rate of progression of disease. Patient co-morbidities must also be considered and a multidisciplinary approach is vital.

First-line therapies

image Topical corticosteroids C
image Dapsone C
image Anti-inflammatory antibiotics D
image Systemic corticosteroids C
image Cyclophosphamide C

Treatment-resistant or severe disease