Endoscopic Findings of Laryngopharyngeal and Esophageal Involvement in Autoimmune Bullous Diseases

Abstract

Background and study aims

Autoimmune bullous disease (ABD) is induced by autoantibodies against cell adhesion molecules, and blistering may occur on the mucous membranes of the eyes, nose, mouse, oral cavity, laryngopharynx, and esophagus. The endoscopic prevalence and features of ABD-associated esophageal lesions are not well known. We conducted this investigation to assess the endoscopic prevalence of ABD-associated mucosal lesions. The endoscopic prevalence of mucosal lesions, particularly laryngopharyngeal and esophageal lesions was used as the primary endpoint to assess the significance of upper gastrointestinal endoscopy (UEG), and the clinical and endoscopic features were secondary endpoints.

Results

Of 123 ABD patients, 50.4% had apparent oral or laryngopharyngeal lesions and 30.8% had laryngopharyngeal lesions. Esophageal lesions were detected through normal observation in 16.8% of affected patients, whereas 40.6% exhibited epidermolysis or blood blisters via mechanical inducement, regardless of esophageal mucosal lesion detection via normal observation. Additionally, 56.0% exhibited the Nikolsky sign with mechanical inducement.

Of the 123 patients, 29.2% did not have exposed skin lesions. Of these patients, 77.7% had oral cavity or laryngopharyngeal lesions, 36.1% had esophageal lesions, and 58.3% exhibited the Nikolsky sign on esophageal mucosa.

Conclusions

It is important to determine the endoscopic characteristics and findings of ABD. ABD could be suspected from endoscopic findings.

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