This study aimed to identify the clinical features of mucous membrane pemphigoid （MMP） and pemphigus vulgaris （PV）, which are autoimmune bullous diseases, and to clarify the characteristics of the oral lesions that develop in these diseases. Data from 59 patients （27 MMP and 32 PV） were collected by retrospective chart review. The site most affected was the gingiva （93％）, showing desquamative gingivitis. 27 of the 59 （46％） patients were confirmed to have extra-gingival lesions. A statistically significant difference was found in extra-gingival lesion development between the patients with MMP （26％） and PV （63％）. Single-site oral lesions were found in 20 MMP （74％） and 12 PV （38％）. Multi-site oral lesions were observed in one MMP （4％） and 11 PV （34％）. There was a statistically significant difference in the single- or multi-site category between the two groups. In conclusion, MMP and PV should be included in the differential diagnosis for the patients with desquamative gingivitis. In patients with MMP, oral lesions were confined to the gingiva and extra-gingival lesions were uncommon. By contrast, in patients with desquamative gingivitis associated with PV, extra-gingival lesions were found at multiple sites.

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Immune thrombocytopenia （ITP） is often accompanied by oral symptoms, and it is well know that one of the causes is Helicobactor pylori （H.pylori） infection. We report a case of acute ITP associated with H.pylori infection diagnosed with the appearance of multiple intraoral hematomas. The patient is 78-year-old woman who shows systemic petechial and multiple intraoral hematomas. Her platelet count was 0.3×10⁴/μl, and she was positive for anti-H.pylori antibody. She was treated immediately by intravenous administration of 20mg/day of methylprednisolone and 10g/day of immunoglobulin, and transfusion of 20 units of platelet concentrate. She was also treated for eradication of H.pylori. Her platelet count has recovered and her progress is good.

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We report a rare case of tongue ulceration caused by cytomegalovirus （CMV） infection, together with a review of the Japanese literature. The patient was an 82-year-old woman who was receiving treatment for rheumatoid arthritis and consulted our hospital with a chief complaint of tongue ulcer. By biopsy, the lesion was diagnosed as an ulcer caused by CMV infection, however, improvement was observed during follow-up observation.
In Japan, only nine cases of oral CMV infection have been reported including the present case, and tongue ulcer was the most common.

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Calcium pyrophosphate dihydrate （CPPD） crystal deposition disease is accompanied by various clinical joint symptoms. Here we report a case of CPPD crystal arthropathy of the left temporomandibular joint.
An 81-year-old woman visited our department with a feeling of pain and swelling in the left temporomandibular joint region. The left temporomandibular joint tumor was suspected on CT images. Also, MRI findings suggested a tumor lesion.The patient underwent surgery to remove the temporomandibular joint tumor under general anesthesia. The results of histopathological examination led to a diagnosis of CPPD crystal deposition disease. In addition,the author is considered it to be CPPD crystal arthropathy with deformity of the temporomandibular joint.

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