Below is a basic overview of PV and MMP. For a clinical overview, click here.
Pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) are chronic, autoimmune diseases that target proteins essential in holding together skin and mucosal epithelial cells. When these proteins are attacked, blistering of the tissue occurs. Autoimmune destruction of the cellular “cement” results in multiple, chronic ulcerations and erosions of the skin and/or mucosa. PV lesions result from destruction of the cementing proteins between epithelial cells, and MMP lesions result from destruction of the cementing protein that anchors the overlying epithelium to the underlying connective tissue. Pemphigus and pemphigoid (P/P) each affect fewer than 50,000 people in the United States, classifying these disorders as ultra-rare illnesses. Lesions associated with PV/MMP are NOT contagious. It is important for patients to know that they did not get PV/MMP from anyone, nor can they give it to anyone else. PV/MMP cannot be transmitted through touch or by blood or fluids. Both PV and MMP can be managed effectively with medication, but every case is different. It is important for patients to work closely with their healthcare provider since these disorders can go into remission, but can also recur at later times.
Both diseases typically begin in individuals 50-60 years old, but can occur at any age. In a 2011 IPPF survey, 63.2% of P/P patients (N=87) reported lesions occurred first in the mouth (labial and buccal mucosa, gingivae, tongue, or throat). Lesions of PV and MMP begin as fragile, large, fluid-filled blisters (bullae), which rupture to form large, coalescing, non-healing ulcerations. However, in many cases, the bullae may not be evident to the patient or clinician. Importantly, 80% of PV patients experience oral lesions before skin lesions, and about 25% of patients have oral lesions exclusively throughout their illness. When PV affects the skin, lesions typically occur on the upper chest, back, scalp, and face. Similar to PV, MMP lesions occur first in the mouth compared to other mucosal surfaces (ocular, genital, nasal, anal).
Below are images depicting the typical appearance of PV and MMP lesions. For more photos and a closer examination, visit here.
Mucous Membrane Pemphigoid: Typical/Moderate Appearance