A Challenging in Diagnosis of Mucous Membrane Pemphigoid with Desquamative Gingivitis Presentation: A Case Report

Desquamative gingivitis (DG) is a descriptive term, indicating inflamed and peeling gingiva. It is characterized by sloughing of the gingival epithelium as a result of formation and rupture of the vesicle. Consequently, the gingiva appears erythematous and often edematous. Desquamative gingivitis may represent an oral clinical manifestation of various systemic mucocutaneous diseases. This case report is on a 42-year-old female with chief complaint of burning sensation in the anterior maxillary gingiva. The patient did not have any other lesion at other sites of the oral cavity. The patient had been affected by asthma and her medications were salbutamol spray and tab cetirizine. Clinically, anterior gingiva appeared as the presentation of desquamative gingivitis. Therefore, an incisional biopsy of the affected area for histopathologic assessment and an incisional biopsy of clinically normal-appearing gingiva for direct immunofluorescence (DIF) study were performed. The histopathologic report was herpes simplex infection. However, this report was incompatible with the clinical view and the patient history. Therefore, a second biopsy was performed. The second histopathologic report was compatible with MMP. The treatment plan was local corticosteroid with follow-up. At the one-month examination visit, a significant improvement was observed in the clinical view of the gums.