Age: 67.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Oral soft tissue biopsy, Pemphigoid
Clinical narrative: I received the J & J vaccine in March 2021.  A few weeks later I began to have sharp pain  in my gums when using a water flosser.  I have been using a water flosser for many years without  any adverse side effects. .  I also noticed that my gums were sloughing skin on the right  side of my mouth.  I brushed it off as  having burned my mouth. As I had been healthy my  entire life, I treated this oral pain with OTC medication and stopped using the water flosser.   I assumed that this would heal on its own and did not really worry about it.   But a few weeks   later the sloughing moved to the left side of my mouth.  In August I finally managed to get  an appointment with my dentist.  He said he did not know what was causing this issue and told me to see a periodontist.  I saw a periodontist on Aug 30 who said I had Lichen Planus infection, and he performed a biopsy to verify.  On Sept 22 he called me with the results of the biopsy, diagnosing Mucous Membrane Pemphigoid.  My primary care physician told me to see  an ophthalmologist and a dermatologist.  The dermatologist took a biopsy with the same results.  As of now the only symptoms are oral.  This is a rare auto immune disease that is chronic and progressive. Below is information I got  Mucous Membrane Pemphigoid  General Discussion Mucous membrane pemphigoid (MMP) is a group of rare chronic autoimmune disorders characterized by blistering lesions that primarily affect the various mucous membranes of the body. The mucous membranes of the mouth and eyes are most often affected. The mucous membranes of the nose, throat, genitalia, and anus may also be affected. The symptoms of MMP vary among affected individuals depending upon the specific site(s) involved and the progression of the disease. Blistering lesions eventually heal, sometimes with scarring. Progressive scarring may potentially lead to serious complications affecting the eyes and throat. In some cases, blistering lesions also form on the skin, especially in the head and neck area. The exact cause of MMP is unknown.  MMP has been known by many different names within the medical literature including benign mucous membrane pemphigoid, cicatricial (scarring) pemphigoid, and ocular cicatricial pemphigoid. In March of 2002, a consensus group of researchers determined that mucous membrane pemphigoid was the best designation for this group of disorders. The term "benign" mucous membrane pemphigoid was deemed inappropriate because of the potential for serious complications in some cases. The term "cicatricial" pemphigoid excluded affected individuals who do not develop scarring. Site-specific terms such as "ocular" cicatricial pemphigoid excluded individuals with multiple site involvement.  Signs & Symptoms MMP is characterized by the development of recurring blistering skin lesions affecting the mucous membranes of the body. These lesions may result in scarring of the affected area. Specific symptoms and severity vary from person to person depending upon the specific site(s) involved. It is important to note that affected individuals, in most cases, will not have all of the symptoms listed below.  The mucous membranes lining the mouth and eyes are most commonly affected. In some cases, the first sign of MMP is a red and blistered mouth. The gums (gingivae), roof of the mouth (palate), and the mucous membrane lining the inner cheek (buccal mucosa) may be affected. Involvement of the gums usually results in very red, tender gums that bleed easily and tend to slough off in shreds or sheets. Blistering lesions may spread to affect the tube that carries food from the mouth to the stomach (esophagus) as well as the voice box (larynx) potentially resulting in difficulty swallowing (dysphagia) and hoarseness. After these lesions heal, progressive scarring may occur, resulting in serious complications including narrowing (stenosis) of the esophagus and/or the larynx. In addition, the opening between the vocal cords (supraglottic region) may also narrow (supraglottic stenosis). In rare severe cases, such symptoms can ultimately result in life-threatening complications such as asphyxiation (breathing is cut off).  In many cases of MMP, the mucous membranes lining the eyes (conjunctiva) may be involved. Inflammation of conjunctiva (conjunctivitis) or erosions forming on the conjunctiva may be the initial signs of ocular involvement in MMP. Involvement of the eyes may not be obvious at first, however, and only a special examination by an eye doctor (ophthalmologist) can detect the earliest scarring that develops just beneath the conjunctiva. In most cases, one eye is involved first and the second eye becomes involved later, usually with two years. Ocular symptoms may include pain or grittiness of the eye, increased pressure within the eye (glaucoma), abnormal inward turning of the eyelid (entropion), and abnormal inward turning of the eyelashes (trichiasis) potentially causing irritation of the eyeball. Adhesions may form between the eyelids (symblepharon) or between the eyelid and the eye itself. In some cases, MMP may progress to cause clouding (opacity) of the corneas, loss of vision and, potentially, blindness.  In some cases, affected individuals may develop blistering lesions affecting only the eyes or the mouth, with no involvement of other mucosal sites. Scarring occurs with less frequency in cases of MMP that only involve the mucous membranes of the mouth (oral mucosa). Additional sites where lesions may form include mucous membranes of the nose, genitalia, and anus. Pain, bleeding and scarring may occur at these sites. Urinary and sexual dysfunction may result secondary to genital involvement.  In approximately 20-30 percent of cases, the skin may become involved. In these patients, the skin of the head and neck is usually affected. Skin lesions may be either fluid-filled blisters (bullous) or reddish (erythematous) plaques, which may bleed or itch. Eventually they scar upon healing. Scarring may result in areas of discoloration of the skin (known as hyperpigmentation when it is darkened patches and hypopigmentation when it is light patches). Involvement of the scalp may lead to patchy areas of hair loss (alopecia).  MMP usually has a long duration with frequent remissions and recurrence.  Causes The exact cause of mucous membrane pemphigoid is unknown. MMP is an autoimmune disorder. Autoimmune disorders are caused when the body's natural defenses (antibodies or immunoglobulins) against "foreign" or invading organisms (antigens) begin to attack healthy tissue for unknown reasons. The term autoantibody is used to describe antibodies that are created to attack healthy tissue. The term autoantigen ("self" antigen) is used to describe the normal tissues and cells of the body that are targeted by the autoantibodies.  In patients who have MMP, autoantibodies are being produced that attack the basement membrane zone (BMZ) of the epithelium. The BMZ can be thought of as a sort of "glue" that holds the outer layer of skin (epidermis or oral epithelium) onto the underlying tissues. Once this glue is attacked and destroyed by the autoantibodies, the skin is no longer tacked down, allowing it to lift off and produce blisters.  Researchers believe that in some cases affected individuals may have a genetic susceptibility to developing some forms of MMP. In these cases several factors may contribute to the development of the disorder including immunological, genetic, environmental, and/or other factors. !!!!!!NOT ONE SINGLE PERSON IN MY GENETIC HISTORY, NEITHER MATERNAL OR PATERNAL HAS BEEN DIAGNOSED WITH AN AUTO IMMUNE DISEASE!!!!!!  In a very small number of patients, MMP may be caused by the use of certain prescription drugs. Skin lesions associated with some cases of MMP may appear following trauma to the affected area. Some cases of MMP affecting the eyes may become apparent after eye (ocular) surgery such as cataract removal.  Affected Populations Mucous membrane pemphigoid is a rare group of autoimmune blistering disorders that affects females twice as often as males. The average age of onset of MMP is during the seventh decade (60 to 70 years of age). However, the disorder can occur at any age. The exact incidence of MMP is unknown. Because the disorder is difficult to identify, many researchers believe it is under-diagnosed.  AS  UP CAN SEE, THIS IS A SERIOUS DISEASE WITH DEVESTATING SYMPTOMS.  I HAVE NO HISTORY THAT WOULD EXPLAIN THIS DISEASE OTHER THAN THE CO VID VACCINE THAT PRODUCES ANTIBODIES IN YOUR IMMUNE SYSTEM.  ON TOP OF THAT I AM FACING THE POSSIBILITY OF REQUIRING TOTAL CARE DUE TO BLINDNESS, AS WELL AS FINANCIAL RUIN TRYING TO AMERLORATE THE SYMPTOMS OF THIS DISEASE