Oral pemphigus vulgaris: a review of the literature and a report on the management of 12 cases.

Twelve cases of oral pemphigus vulgaris are described to illustrate the long-term behavior of the disease and the treatment challenges it presents to the oral medicine practitioner. In addition, we review the literature on oral pemphigus vulgaris with respect to clinical history, signs and symptoms, management, and treatment outcome. Pemphigus vulgaris is a chronic vesiculobullous disease with a potentially fatal outcome. Mortality from pemphigus vulgaris before the development of effective therapies was as high as 90%. Today, with treatment, it is closer to 10%. Involvement of the oral mucosa is common and in most cases precede skin lesions; in our patients, the oral lesions preceded the development of extraoral disease in 75% of cases. Pemphigus vulgaris was more frequent among women (9:3), and there was a tendency for the severity and frequency of disease to decrease with time.