PMC7772047_01
Initial characteristic of the gingiva with an erythematous aspect and with sulcus suppuration. Intraoral image of the patient at the initial examination.
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Intraoral clinical examination showed exacerbated accumulation of dental biofilm, erythematous and swollen gingiva, and mild pain (Figure 1).
(a) Displacement of the epithelium after an air jet over the buccal gingiva, causing blisters (Nikolsky positive sign). (b) Removal of the gingival fragment. (c) Surgical cement to protect the surgical area. Intraoral images before treatment: (a) Nikolsky's sign; (b) appearance after the incisional biopsy;(c) appearance with the surgical cement.
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An air jet was applied to the mucosa, and Nikolsky's sign (Figure 2(a)) was observed. It was a difficult procedure owing to epithelial detachment and fragility (Figure 2(b)). Surgical cement was used as a postoperative dressing (Figure 2(c)).
Follow-up after prednisone treatment. Intraoral image 40 days after the beginning of treatment, showing erythematous gingiva.
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However, the gingiva remained erythematous (Figure 3).
Histopathological sections of the removed tissue stained with hematoxylin and eosin. a) Slide showing the absence of epithelium with exposed connective tissue. b) Submucosal tissue showing the blistering lesion.
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The anatomopathological examination results were compatible with BMMP (Figure 4).
Improvement without signs of bleeding after 3 months. Photograph of intraoral aspect in the last follow-up consultation.
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The patient's symptoms steadily improved, with no apparent pain and bleeding. (Figure 5).