Tratamento do pênfigo vulgar oral com corticosteróides tópico e sistêmico associados a dapsona e pentoxifilina
Treatment of oral pemphigus vulgaris with topic and sistemic corticosteroid associated with dapsone and pentoxifylline
Bernabéa, D.G.; Moraes, N.P.; Correia, C.M.; Furuse, C.F.; Crivelini, M.M.
Rev. odontol. UNESP, vol.34, n1, p.49-55, 2005
Resumo
O pênfigo vulgar é uma doença mucocutânea crônica de origem auto-imune caracterizada pela formação de vesículas e/ou bolhas que, ao se romperem, dão origem a dolorosas ulcerações na superfície das mucosas e pele. Sem tratamento, o pênfigo vulgar é considerado de prognóstico fatal. Tem-se obtido o controle da doença com o uso terapêutico de corticosteróides sistêmico e tópico em associação com drogas imunossupressoras coadjuvantes. Neste trabalho, é apresentado um caso de pênfigo vulgar oral em uma mulher branca com 27 anos de idade, cujo quadro clínico principal era de gengivite descamativa e dor bucal. O tratamento, constituído de corticosteróide tópico (gel à base de hidrocortisona) aplicado sobre as gengivas lesionadas por meio de moldeira acrílica individual, de corticosteróide sistêmico (prednisona) e das drogas coadjuvantes dapsona e pentoxifilina, revelou-se benéfico para o controle da doença. Também são revisadas as características clínicas e a importância do diagnóstico precoce do pênfigo vulgar pelo cirurgião-dentista quando a doença acomete a mucosa bucal.
Palavras-chave
Pênfigo, corticosteróides, dapsona, pentoxifilina
Abstract
Pemphigus Vulgaris is a chronic autoimmune mucocutaneous disease characterized by intra-epithelial bulla formation which rupture causes painful ulcerative lesions in the mucous membrane and skin. Without any treatment pemphigus vulgaris may cause serious life-threatening effects and it has been controlled by the usage of systemic and topic corticosteroids associated with adjuvant immunosuppressive drugs. The case reported in this study refers to a 27 year-old white woman presenting desquamative gingivitis and oral pain. Topical corticosteroids treatment (hydrocortisone gel) applied with individual acrylic resin tray directly on the injured gingivae, systemic corticosteroids (prednisone) and adjuvant drugs (dapsone and pentoxifylline) therapy have presented favorable effects to control the disease. Clinical features of pemphigus vulgaris have been reviewed and the importance of early diagnosis made by dentists when the disease affects the oral mucosa has been emphasized in this study.
Keywords
Pemphigus, adrenal cortex hormones, dapsone, pentoxifylline
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