The disease course is almost always fatal within two years and is the only form of pemphigus in which internal organs are affected. The erosive form of lichen planus presents intraorally as an atrophic, erythematous area with central ulceration of varying degree. Patients usually complain of open sores in the mouth and may have characteristic skin lesions often described as purple, pruritic, polygonal papules. A biopsy specimen should be obtained to determine the diagnosis. The epithelium displays saw-tooth like rete pegs as well as significant blurring of the basement membrane.
Treatment usually consists of topical corticosteroids although systemic use is a viable alternative.
Middle age women are affected most often. Generally, it is difficult to differentiate the clinical manifestations of this disease from those of cicatricial pemphigoid. In conclusion, a good understanding of the similarities and differences between pemphigoid and pemphigus is essential to a dental practice. The dentist should be able to develop a differential diagnosis, as well as understand the importance of biopsy to determine the nature of their patient s lesions. Knowledge of how to handle a biopsy specimen and the ability to interpret the pathologic report becomes an important tool in appropriate patient care.