Oral Manifestations of Autoimmune Blistering Diseases

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Medication Summary
The treatment strategy for oral manifestations of autoimmune blistering diseases generally is the same as the treatment for the autoimmune blistering diseases themselves; therefore, please see Pemphigus Vulgaris, Bullous Pemphigoid, and Linear IgA Dermatosis for treatment options for those patients with these diseases who have oral involvement.

For cicatricial pemphigoid (mucous membrane pemphigoid) in which mucous membranes primarily are affected, the treatment strategy is discussed in detail in a separate article; therefore, the treatment for mucous membrane pemphigoid is not discussed herein. Adjunct treatments particularly relevant to oral lesions as a result of these autoimmune diseases are outlined below.

Anti-inflammatory agents
Class Summary
Used to treat oral lesions.

Clobetasol (Temovate)

Suppresses mitosis and increases synthesis of proteins that decrease inflammation and cause vasoconstriction. Class I superpotent topical steroid useful in treating oral lesions. Topical corticosteroids commonly are used intraorally for oral manifestations of autoimmune blistering skin diseases. Since these diseases are chronic inflammatory in nature, topical corticosteroids are very useful as an adjunct treatment. Patients with disease confined to the gingiva should see a dentist to have a custom-made soft tray to carry the medication.

Dapsone (Avlosulfon)

Mechanism of action is similar to that of sulfonamides, in which competitive antagonists of PABA prevent formation of folic acid, inhibiting bacterial growth. Anti-inflammatory mechanism of action remains unknown but probably relates to suppression of neutrophil function. Used alone or in conjunction with other anti-inflammatory medications or immunosuppressives for oral lesions.

Tetracycline (Sumycin)

Mechanism of action probably is by its anti-inflammatory properties, although it is an antibiotic by nature. Can be used alone or in conjunction with niacinamide.

Niacin (Vitamin B-3)

Source of niacin used in tissue respiration, lipid metabolism, and glycogenolysis.