Oral biopsy in mucous membrane pemphigoid and pemphigus vulgaris with gingival expression: the optimal site. A systematic review and meta-analysis

Abstract Purpose In order to diagnose mucous membrane pemphigoid (MMP) and pemphigus vulgaris (PV) with gingival expression, clinical data must be compared with immunohistochemical data obtained using direct immunofluorescence (DIF). It is therefore essential to carry out a good quality mucosal biop...

Full description

Saved in:
Bibliographic Details
Main Authors: Sophie-Myriam Dridi (Author), Claire Manon Lutz (Author), Frédérick Gaultier (Author), Fadel Bellakhdar (Author), Sébastien Jungo (Author), Anne Laure Ejeil (Author)
Format: Book
Published: BMC, 2024-09-01T00:00:00Z.
Subjects:
Online Access:Connect to this object online.
Tags: Add Tag
No Tags, Be the first to tag this record!

MARC

LEADER 00000 am a22000003u 4500
001 doaj_ba0fae40c1df4dd09a917e0d0c24f7c1
042 |a dc 
100 1 0 |a Sophie-Myriam Dridi  |e author 
700 1 0 |a Claire Manon Lutz  |e author 
700 1 0 |a Frédérick Gaultier  |e author 
700 1 0 |a Fadel Bellakhdar  |e author 
700 1 0 |a Sébastien Jungo  |e author 
700 1 0 |a Anne Laure Ejeil  |e author 
245 0 0 |a Oral biopsy in mucous membrane pemphigoid and pemphigus vulgaris with gingival expression: the optimal site. A systematic review and meta-analysis 
260 |b BMC,   |c 2024-09-01T00:00:00Z. 
500 |a 10.1186/s12903-024-04853-y 
500 |a 1472-6831 
520 |a Abstract Purpose In order to diagnose mucous membrane pemphigoid (MMP) and pemphigus vulgaris (PV) with gingival expression, clinical data must be compared with immunohistochemical data obtained using direct immunofluorescence (DIF). It is therefore essential to carry out a good quality mucosal biopsy for this vital additional test. To date, no study has been able to effectively guide clinicians in their choice of oral site for biopsy to guarantee the efficient contribution of DIF to diagnosis. We propose a systematic review of the literature and a meta-analysis to clarify this issue. Materials and Methods Electronic databases and bibliographies of articles were searched in April 2023. The primary outcome was the rate of DIF + contribution to diagnosis according to the location of the oral site biopsied. Results 16 studies were included. Gingival biopsies showed a rate of DIF + 100% [97%-100%] p = 0.998 I2 = 0.0% with no heterogeneity for PV, and 90.2% [66.5%-100%] p < 0.001 I2 = 89.6% with high heterogeneity for MMP. For the other oral sites, this rate was 95.7% [87.4%- 100%] p = 0.011 I2 = 73.0% with moderate heterogeneity for PV, and 87.4% [70.1%- 98.7%] p < 0.001 I2 = 92.6% with high heterogeneity for MMP. In addition, meta-regression confirmed the significant association between the appearance of the biopsied mucosa and the rate of DIF + in MMP (p < 0.001), with no influence on residual heterogeneity. Conclusion The nature of the oral mucosa biopsied does not influence the rate of DIF + to diagnosis. The choice of biopsy site should only take into account the characteristics of the clinical picture and the benefit/risk balance of the surgical protocol. The sample must be taken in healthy aeras as close as possible of active lesions: on the gingiva if the MMP and PV are strictly gingival, on the alveolar mucosa if the whole gingiva is altered and on any healthy mucosa if a large number of oral sites are affected. Clinical trials CRD42023392345. 
546 |a EN 
690 |a Oral biopsy 
690 |a Desquamative gingivitis 
690 |a Mucous membrane pemphigoid 
690 |a Pemphigus vulgaris 
690 |a Dentistry 
690 |a RK1-715 
655 7 |a article  |2 local 
786 0 |n BMC Oral Health, Vol 24, Iss 1, Pp 1-27 (2024) 
787 0 |n https://doi.org/10.1186/s12903-024-04853-y 
787 0 |n https://doaj.org/toc/1472-6831 
856 4 1 |u https://doaj.org/article/ba0fae40c1df4dd09a917e0d0c24f7c1  |z Connect to this object online.