Optimization of oral mucosa care in pemphigus vulgaris

Background. The incidence of autoimmune diseases is increasing every year. It should be mentioned that early signs of the pathology often emerge on the oral mucosa. Among dermatological conditions, pemphigus vulgaris is classified as such. This type of the disease starts with oral rashes in 50% of cases. However, erosive and ulcerative lesions of the oral mucosa occur in 70-90% of cases. The etiology of pemphigus vulgaris is unclear. From a pathophysiological perspective, pemphigus manifests with the development of autoantibodies against intercellular substance. Clinical features present as intraepithelial blister formation on the skin and mucous membranes.

Results. Topical and systemic glucocorticosteroids are the first-line therapy. In cases of severe forms and torpid course, the treatment regimen includes immunosuppressive drugs. The localization of eruptions in the oral cavity significantly limits the range of available therapeutic options. Furthermore, due to the anatomical features of the region, there is a high risk of rapid secondary infection.

Conclusion. One of the medications accessible for the treatment of erosive and ulcerative lesions of the oral cavity is a combination of undecylenamidopropyl betaine at a concentration of 0.1% and Polyhexamethylene biguanid (polyhexanide) at a concentration of 0.1%. Polyhexanide is an antiseptic. It has been used in clinical practice for decades. It is colorless, odorless, soluble in water and alcohol and possesses bactericidal and fungicidal properties. Our experience indicates its high efficacy and good tolerability in patients with oral manifestations of pemphigus vulgaris. Clinically significant improvement is observed after two weeks of therapy. The drug is associated with a favorable impact on patients' quality of life, given that painful erosive eruptions substantially impact the ability to consume food and cause severe discomfort.

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