The first manifestations of PV are on the oral mucosa in the majority of patients |
In these patients, oral manifestations are the sole symptoms of the disease until cutaneous lesions appear 2-6 months later |
Oral blisters have a very thin roof and readily rupture due to trauma, giving rise to chronic painful bleeding ulcers and erosions that heal with difficulty |
The most frequent sites of oral lesions are those subject to friction |
PV should be suspected in cases of persistent gingivostomatitis, persistent and multiple oral erosions, or severe desquamative or erosive gingivitis |
The most frequent diagnoses in cases of oral lesions are recurrent aphthous stomatitis, Behçet’s disease, erythema multiforme, erosive lichen planus, and oral candidiasis |
Lesions of the oral mucosa in patients with low antibody titers may be controlled with mouthwashes or topical creams containing corticosteroids |
Intralesional injection of triamcinolone acetonide or paramethasone can be used in refractory oral lesions |
The wellbeing of patients may be improved by: analgesics, a strict oral hygiene with diluted antiseptic mouthwashes, a soft diet without irritants, correct prosthetic restorations, and anti-candida therapy |
Traumatisms may trigger or exacerbate PV, therefore some authors recommend the prophylactic use of prednisolone (20 mg/day) for 5-7 days before dental procedures involving gums |