Patterns of oral mucosa lesions in patients with epidermolysis bullosa: comparison and agreement between oral medicine and dermatology
Article first published online: 15 JUN 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Journal of Oral Pathology & Medicine
Volume 42, Issue 10, pages 733–740, November 2013
How to Cite
J Oral Pathol Med (2013) 42: 733–740
- Issue published online: 7 NOV 2013
- Article first published online: 15 JUN 2013
- Manuscript Accepted: 16 MAY 2013
- Department of Dermatology, Stanford University, Stanford
- Office of Research and Development, Palo Alto Veteran's Affairs Medical Center
- D.eb.R.A. Mexico
- bullous lesions;
- oral mucosa
The oral mucosa in patients with epidermolysis bullosa (EB) can be affected with different lesions and degrees of severity. However, patterns of oral lesions in distinct types of EB are still unclear.
The purpose of this study was to determine the frequency and distribution of four types of lesions (erythema, erosion, atrophy, and blister) for each oral site and to calculate the interobserver reliability for each type of lesion in each site.
Ninety-two patients with different EB types were assessed independently by an oral medicine specialist and a dermatologist. The degree of agreement was calculated by the intraclass correlation coefficient (ICC).
The most affected oral site was the tongue, with the most frequent lesion being erythema and atrophy [54(58.7%) patients] for the oral medicine specialist and erosion [54(58.7%) patients] for the dermatologist. Patients with recessive dystrophic EB-severe generalized (RDEB-sev gen) showed the highest mean of sites involved by each lesion for both oral medicine and dermatology. The interobserver reliability on the total of lesions was excellent on only 3 sites: lower lip (ICC: 0.89; 95%CI:0.83–0.92), hard palate (ICC:0.85; 95%CI:0.72–0.91), and tongue (ICC:0.89; 95%CI:0.84–0.92), whereas the interobserver reliability calculated for each single oral lesion showed a lower agreement.
Total distribution of sites involved by four types of lesions was higher in RDEB-sev gen than in the rest of EB types, with a predominance of erythema followed by erosion. The agreement on the type of lesion was found to be poor-moderate for many oral sites.