Scarring can result from the persistent, rare autoimmune blistering condition known as cicatricial pemphigoid. It may only affect mucous membranes, only the skin, or both the skin and mucous membranes. The condition is frequently referred to as “mucous membrane pemphigoid” when it exclusively affects the mucous membranes. It may be called ocular pemphigoid if just the ocular membranes are affected. Scarring risk varies depending on where the disease is active. A difficult initial diagnosis may arise. Early and urgent treatment may be necessary due to the dangers of significant consequences like blindness and airway impairment.

Introduction:

A set of uncommon, persistent acute blistering disorders that mostly affect the mucous membranes, especially the conjunctiva, and sporadically the skin are referred to as mucous membrane pemphigoid (MMP), also known as cicatricial pemphigoid. Tight blisters and erosions are frequently found on the head, neck, or at the sites of trauma in patients with cutaneous involvement. The term “cicatricial” refers to the widespread scarring of the mucous membranes, which can cause blindness, impaired vision, and supraglottic stenosis with hoarseness or airway obstruction.

The skin’s basement membrane, which joins the lower skin layer (dermis) to the higher skin layer (epidermis) and keeps it linked to the body, is where the autoimmune reaction manifests itself. When the illness is active, the antibodies generated break down the basement membrane, causing sections of skin to pull away at the base and form hard blisters that leave scars if they rupture. Or, to put it another way, it is a desquamating/blistering illness in which the epithelium “unzips” from the underlying connective tissue, enabling fluid to collect and eventually emerge as bullae, or blisters.

Causes:

Most cicatricial pemphigoid cases are typically diagnosed clinically by simply looking at the lesions. However, certain patients might require a biopsy to determine the course of treatment. It’s crucial to get an early diagnosis of cicatricial pemphigoid. For instance, oral and cutaneous cicatricial pemphigoid patients can mimic pemphigus. Similar to how cases of melasma or ashy dermatosis might resemble cicatricial pemphigoid pigmentosa.

Having a keen eye and the ability to distinguish between cases of oral pemphigoid, leukoplakia (a precancerous condition of the mouth), and oral submucous fibrosis are essential for a successful clinician. It is unknown what the exact prevalence and incidence are. In a French study, the incidence of cicatricial was estimated to be 1.16 per million per year. According to a German study, there are 0.87 cases of cicatricial pemphigoid per million people each year.

According to a Greek study, the average age at which cicatricial pemphigoid first manifests itself is 66 years old, with a 1.5:1 female predominance. In a German community, the female-to-male ratio for cicatricial pemphigoid was found to be as high as 7:1.

Symptoms:

The oral mucosa in the mouth is the area of the body where the autoimmune reaction most frequently occurs, leading to desquamative gingivitis, or gum sores. Areas of the mucous membrane in other parts of the body, such as the sinuses, genitals, anus, and cornea, can also be impacted in more severe cases. Blindness may occur as a result of repeated scarring to the cornea of the eye. Ecological, emotional, and mental shifts have a significant negative impact on our bodies, particularly our immune systems. This stress makes the immune system behave unnaturally, even in the simple, innocent body.

Diagnosis:

Cicatricial pemphigus can be diagnosed, typically based on clinical presentation. As a chronic vesiculobullous condition, flaccid bullae that rupture and leave behind non-healing erosions can be clearly seen. Positive signs of the Nikolsky and Bulla spreads are observed. Oral erosions that hurt can be seen. Tzanck smear, histological, and immunopathological tests can all be used for confirmation.

Homeopathic Treatment for the disease:

Conventional medicine cannot cure cicatricial pemphigus; it can only provide temporary relief. However, homeopathic medicine can rectify the dysfunction at the mental, emotional, and psychological levels as well as the fundamental triggering factors. Homeopathic treatments including Arsenic album, Sulphur, Natrum muriaticum, Apis Mellifica, Borax, Thuja occidentalis, and Kali chloratum have been discovered to be quite effective at treating the disease’s disordered immunity, which is considered to be its primary cause.

The length of the treatment depends on how long the patient has been ill. The length of the required treatment depends on how chronic the condition is. If steroids were administered for a longer amount of time during the initial treatment, the result is a complex disease that is difficult to manage. Compared to oral lichen planus, lichen planus of the scalp, and lichen planus of the genitalia, skin lichen planus is generally easier to treat. Some of the basic functions of homeopathic remedies are:

• Arsenic album. symptoms include eruption and papular skin that is dry, rough, and itchy. insulting discharge. Skin epithelioma.
• Bufo Rana. Layers of skin with lost sensation, suppuration, and pustules from even the smallest wounds. Pemphigus.Bullae that break open and exude an ichorous fluid and leave a rough surface. Blistering on the soles and palms. the burning and itching.
• Caltha palustris. A ring surrounds the bullae. Numerous itches. Face significantly enlarged, particularly around the eyes. A rash of itching on the thighs. Pustules.
• The ranunculus bulb has been used to treat pemphigus and vesicular eruptions. Intensive itching and burning, worsened by contact. brittle excrescences. palm outbreak resembling a blister. eruption with pustules and vesicles. horny surface. Palm and fingertip skin is chapped.
• Pemphigus ranunculus sceleratus helps to overcome vesicular eruption that frequently produces sizable blisters. Exudation that is acrid and hurts the nearby tissues. pronounced dull biting ache.
• Rhus Toxicodendron is used for red, bloated, and extremely itchy. Vesicular suppurative forms, herpes vesicles, urticaria, pemphigus, and erysipelas. eczematous eruptions that burn and tend to produce scales.