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Oral Health Care Management in Atypical Oral and Cutaneous Bullous Pemphigoid Widowati, Kharinna; Dewanthy P, Sri; Lukisari, Cane; Nafi’ah; Setianingtyas, Dwi; Rahman, Kurnia Hayati; Libriansyah; Riyanto, Eko; Damaiyanti, Dian W; Ayuningtyas, Nurina F.
Denta Journal Kedokteran Gigi Vol 20 No 1 (2026): February
Publisher : Fakultas Kedokteran Gigi Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/denta.v20i1.4

Abstract

Background: Bullous Pemphigoid (BP) is the most common subepidermal bullous autoimmune disease, typically presenting as tense bullae. Atypical presentations of bullous pemphigoid often mimic TEN or impetigo, creating diagnostic ambiguity. Effective management of these cases requires integrated strategies to address systemic health factors and extensive oral mucosal involvement. Objective: This report highlights the Oral Health Care Management of atypical oral and cutaneous manifestations of Bullous Pemphigoid. Case: A 58-year-old woman with a history of Diabetes Mellitus and heart disease was referred with extensive bullae, erosions, and "honey-like" crusts involving over 30% of her body surface area. Her condition worsened despite two weeks of treatment with acyclovir, which was administered for suspected herpes. The presentation was highly suggestive of TEN and impetigo. Case Management: Management of the oral and perioral lesions focused on infection prevention and pain relief. Debridement was performed using sterile gauze soaked in normal saline and 0.2% chlorhexidine. This was followed by the application of Aloevera extract gel/spray. Comprehensive systemic therapy, including corticosteroids and immunosuppressants, was coordinated by a multidisciplinary team to control the autoimmune disease and its comorbidities. Conclusion: The presence of comorbidities, such as diabetes, further complicates systemic management and heightens the risk of secondary infections, requiring meticulous wound care. A multidisciplinary diagnostic algorithm, supported by supplementary examinations, is crucial for differentiating atypical BP from TEN and impetigo infection. Adequate management of associated oral and perioral manifestations is an integral component of comprehensive patient care.
Co-Authors Ade Puspa Sari Afryla Femilian Aprilia Arifzan Razak Arya Brahmanta Arya Brahmanta Arya Brahmanta, Arya Astrid P Aulia, Della Ayu A, Shintya Rizki Ayuningtyas, Nurina F. Bagus Soebadi Bambang Sucahyo Bunga Fauzia Cane Lukisari Cane Lukisari Cane Lukisari, Cane Cindy Hendrawan Damayanti, Desak Made Feby Desiana Raditya Dewanthy P, Sri Dian Mulawarmanti, Dian Dian W Damaiyanti, Dian W Dimas Iman Dwi Andriani Dwi Andriani, Dwi Elidasari, Monika Erni Marlina Eveline Yulia Darmadi Eveline Yulia Darmadi Fauzia, Bunga Felicia Eda Haryanto Felicia Eda Haryanto Femilian, Afryla Fitria Rahmitasari Hartono, Mardiyanto Riski Henu Sumekar Iman, Dimas Indarti, Caecilia Irmawati, Ari Rosita Isidora KS Iwan Hernawan Kharinna Widowati, Kharinna Kristanti Parisihni Kurnia Hayati Rahman Kusumawardani, Chaterina Diyah Nanik Laihad, Fanny M. Lelyana, Nora Lestari, I.G.A.M Oka Lestari, Oka Libriansyah Mintarsih Djamhari K Mintarsih Djamhari K N. Nafiah Nafi'ah Nafi'ah . Nafi?ah, Nafi?ah Nafiah Nafiah Nafiah Nafiah, Nafiah Nafi’ah Nafi’ah Nafi’ah Nafi’ah, Nafi’ah Neken Prasetyaningtyas Nilawati, Nina Nora Lelyana Oka Lestari Panky Hermawan Pargaputri, Agni Febrina Paulus Budi Teguh Priambodo, Nur Tsurayya Puguh Bayu Prabowo, Puguh Bayu Putra, Ramadhan Hardani Rahman, Kurnia Hayati Rima Parwati Sari, Rima Parwati Riyanto, Eko Saptaswari, Dianty Saptaswari, Dianty Setya i Wardan Setya Wardani Shintya Rizki Ayu Agitha Shintya Rizki Ayu Agitha Shintya Rizki Ayu Agitha, Shintya Rizki Ayu Sularsih Syamsulina Revianti Tantra, Ivan Twi Agnita Cevanti Vivin Ariestania W, Widyastuti Wahjuningrum, , Dian Agustin Widyasri Prananingrum Yemy Ameliana Yemy Ameliana, Yemy Yessy Andriani Fauziah Yessy Andriani Fauziah Yoyada, Novendy Yudhistira Prawira Utama Yufita Fitriani Yulie Emilda, Yulie