Buccal mucosa basement membrane

In addition to the intercellular lipids of the buccal mucosa, there appear to be other barriers which may reduce the ability of an exogenous compound to permeate the buccal mucosa. These include the salivary film and mucus layer, the basement membrane, and a metabolic barrier. 

The cross-sectional structure of the buccal mucosa is shown in Fig. 2.7. The buccal mucosa consists of the epithelium and the underlying connective tissue, the lamina propria, separated by a basement membrane. 

An 86-year-old woman, with a history of stable schizophrenia, chronic obstructive pulmonary disease, ischemic cardiomyopathy, and type 2 diabetes, was admitted with cardiac insufficiency, which was treated by introduction of enalapril. A chest infection was treated with co-amoxiclav with gradual alleviation of sjmp-toms over 10 days. At this point, furosemide was begun, because of persistent signs of heart failure. After 3 days, erythema and bullae were noted on her pahns and soles, and later on the trunk, extremities, hard palate, and buccal mucosa. Biopsy showed the characteristic features of linear IgA bullous dermatosis, with linear deposition of IgA along the basement membrane. Co-amoxiclav and furosemide were withdrawn no new lesions were noted thereafter. 

A bUstering eruption developed in the skin and buccal mucosa of a 79-year-old man after 8 days of vancomycin therapy for an infected leg ulcer (82). Biopsy showed linear IgA deposition along the basement membrane. The lesions cleared spontaneously within two days of withdrawal. 

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