Vol.13, No 3, 2006 pp. 177 - 180
UC 616.527
THE IMPORTANCE OF PATHOHISTOLOGY
IN EARLY DIAGNOSIS OF ORAL PEMPHIGUS
Draginja Kojović1, Ana Pejčić1,
Dragan Mihailović2, Dragan Mikić3
1Department of Parodontology and Oral
Medicine, Medical Faculty, University of Niš
2Institute of Pathology, Medical Faculty,
University of Niš
3Clinic of Dermatovenerology, Military
Hospital, Niš
E-mail: dpejca@nadlanu.com
Summary. Pemphigus vulgaris (PV) is autoimmune disease, where antibodies
are produced against kreatin and adhesive molecules of intercellular substance
in skin epidermis and epithelium of oral mucous membrane. Disease progression
can be slower if there are only oral changes, without other clinical manifestations,
which can interfere with diagnosis and involves a lot of differential and
diagnostic possibilities, as well as therapy hesitations. The aim of our
work was to do pathohistological verifications of oral lesions, in order
to set up early and certain PV diagnosis and to give adequate therapy.
Material was presented by 14 biopsies taken from the patients with oral
changes, which clinically pointed to PV. Hematoxilin-eosin staining was
used. They showed characteristic pathohistologic changes by forming acantholytic
bullae in intercellular areas of spinal epithelium layer. The bottom of
bulla presents basal layer, but the roof the other parts of epithelium.
In bulla contents, individual or in groups acantholytic cells can be seen.
Pathohistological findings set up the certain diagnosis of PV, when there
are only changes on oral mucosa membrane, or in discrete combination with
other mucosa membrane, without skin lesion, which gives patients direction
to dental clinics.
Key words: Pemphigus, oral
mucosa membranae, pathohistological verification
ZNAČAJ PATOHISTOLOGIJE U RANOJ DIJAGNOSTICI
ORALNOG PEMFIGUSA
Kratak sadržaj: Pemphigus vulgaris (PV) je autoimuno oboljenje,
kod koga se stvaraju autoantitela protivu keratinocitnih adhezivnih molekula
intercelularne supstance u epidermu kože i epitelu oralne sluzokože. Progresija
bolesti može biti sporija ako postoje samo oralne promene, bez drugih kliničkih
manifestacija, što otežava dijagnozu i uključuje niz diferencijalno dijagnostičkih
mogućnosti, kao i terapijske nedoumice. Cilj našeg rada bio je da se uradi
patohistološka verifikacija oralnih lezija, radi postavljanja rane i sigurne
dijagnoze PV i uključi adekvatna terapija Materijal je činilo 14 biopsija
uzetih od pacijenata sa oralnim promenama, koje su klinički ukazivale na
PV. Korišćena je Hematoxilin-eosin metoda bojenja. Pokazali su karakteristične
patohistološke promene sa formiranjem akantolitične bule u intercelularnim
prostorima spinoznog sloja epitela. Dno bule predstavlja bazalni sloj a
krov ostali delovi epitela. U sadržaju bule vide se pojedinačne ili u grupama
epitelne akantolitične ćelije. Patohistološki nalaz postavlja sigurnu dijagnozu
PV-a, kada su promene samo na oralnoj sluzokoži, ili u diskretnoj kombinaciji
sa drugim sluzokožama, bez kožnih lezija što pacijenta obično upućuje u
stomatološke ambulante.
Ključne reči: pemphigus, oralna
sluzokoža, patohistološka verifikacija
