Oral Manifestations of Autoimmune Blistering Diseases Medication

Updated: Feb 11, 2019
  • Author: Nita Chainani-Wu, DMD, MS, MPH, PhD; Chief Editor: William D James, MD  more...
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Medication

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 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. [18]

Anti-inflammatory agents are used to treat oral lesions. [40, 41, 42]

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Anti-inflammatory agents

Class Summary

These agents are used to treat oral lesions.

Clobetasol (Temovate)

Clobetasol suppresses mitosis and increases the synthesis of proteins that decrease inflammation and cause vasoconstriction. It is a 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 and inflammatory in nature, topical corticosteroids are very useful as an adjunct treatment. Patients with disease confined to the gingiva should see a dentist for a custom-made soft tray to carry the medication.

Dapsone (Avlosulfon)

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

Tetracycline (Sumycin)

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

Niacin (Vitamin B-3)

This is the source of niacin used in tissue respiration, lipid metabolism, and glycogenolysis.

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