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Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 12-16A case of chronic bullous type mucocutaneus disease involving oral mucosa was reported from a 56 years old man with never healed oral ulcers and wound on the perianal skin for three years. There were also red and black sports on the limb and back skin and a lesion on nail. Painful oral lesion consisted of mucous erosion, desquamative gingivitis, and sloughing area on palate and tongue. The patient is diabetic. The first perianal skin diagnosis was granulomatous candidiasis with differential diagnosis pemphigus vegetans and acuminatum condiloma. However, the histopathologic examination did not support those diagnosis. After several histopathologic examinations, the latest perianal skin diagnosis was lichen planus with differential diagnosis granulomatous vasculitis, bowenoid papulosis and pyoderma gangrenosum. Other skin diagnosis was erythema multiforme. Oral diagnosis was mucous membrane pemphigoid with differential diagnosis lichen planus, Behcet's syndrome and erythema multiforme oral histopathologic examination showed a sub-epithelial blister, which supported mucous membrane pemphigoid. A lip balm, prednisone 5 mg oral rinse and multivitamins were given but oral improvement started after blood sugar level controlled. Conclusion: lt is not yet known whether skin and oral mucous lesions are from the same disease or not. |
