Pemphigus and pemphigoid (P/P) each affect fewer than 50,000 people in the United States, classifying these disorders as rare diseases. P/P are often not on the radar of dental professionals, who are unaccustomed to seeing P/P in practice.
Lack of Awareness
Due to its rarity, it is common for dental professionals to overlook P/P in their differential diagnosis. According to IPPF data collected in 2011, 46% of patients (n=52) who saw a dentist reported their dentist was not knowledgeable about P/P symptoms and performed no action relevant to P/P. The IPPF strives to educate dental professionals and students about P/P, exposing them to continuing education opportunities and patient testimonials.
P/P patients are often misdiagnosed as having a more common illness that is seen more frequently by dental professionals. Clinically, P/P can mimic other oral inflammatory conditions, such as lichen planus, candidiasis, and periodontal disease. The most common misdiagnoses of P/P are erythema multiforme, herpes simplex virus, and candida. Many oral diseases can have similar appearances. A biopsy and immunofluorescent studies are needed to achieve a correct diagnosis.
Dentists considering PV/MMP in their differential diagnosis should perform a biopsy or make a referral to a dental specialist experienced in performing biopsies of vesiculobullous lesions. Unfortunately, patients are not always referred to the appropriate provider, delaying diagnosis. Patients often see five or more providers before receiving a correct diagnosis. Throughout this process, patients are delaying correct treatment, and many experience worsening symptoms.