Oral ulcer and skin lesions: a tell-tale sign of pemphigus vulgaris (original) (raw)
Related papers
Pemphigus Vulgaris as Oral Mucosal Ulcer Progressive to Skin Lesion
Update Dental College Journal, 2014
Among all the life threatening diseases, autoimmune diseases are among most notorious and complicated diseases. As these diseases have no specific cause or responsible organism, it is therefore very difficult to distinguish and diagnose and thus stands as a major threat for public health. It is assumed that the reason for these diseases may be from genetic to environmental factors, from stress to idiopathic origin. Pemphigus Vulgaris(PV) is such an autoimmune blistering disease that frequently affects the mucous membrane and skin. Very often it starts from oral cavity and Dentists therefore the first to recognize. This paper describes the case of a patient presenting with a one-year history of painful ulcerated gingiva, tongue, floor of the mouth and even on GIT who is finally diagnosed as having PV spreading to generalized skin. DOI: http://dx.doi.org/10.3329/updcj.v3i2.17999 Update Dent. Coll. j: 2013; 3 (2): 43-47
Delayed Diagnosis of Pemphigus Vulgaris Initially Presenting as an Oral Ulcer: A Case Report
Journal of Nepal Medical Association
Pemphigus vulgaris is a rare autoimmune mucocutaneous blistering disease clinically presenting as vesicles, bullae, and erosion and histologically characterized by suprabasal split and acantholysis. It usually affects mucous membranes and skin. Recurrent oral ulcers can only be the clinical manifestation before progressing into skin lesions. This can lead to the delayed diagnosis of this disease. Here we report a case of pemphigus vulgaris which was diagnosed after years of suffering from an oral ulcer that eventually progressed to widespread skin blistering and ulceration. The patient was treated with oral prednisolone which showed improvement within a week. Physicians should consider the differential diagnosis of pemphigus vulgaris in patients presenting with a recurrent oral ulcer.
2019
Pemphigus vulgaris (PV) is a group of autoimmune bullous diseases that results in multiple chronic mucocutaneous bullae, erosions, and/or ulcers presenting orally first. Several previous studies reported that viral infections, especially herpes simplex virus (HSV), may trigger activation of pemphigus. The relationship between PV and viral infection can be classified into 3 groups which are casual, such as viral infection due to a complication of immunosuppressive therapy, causal, HSV is a trigger before the pemphigus is present, and studies that were examined for HSV infection in PV patients but could not find any evidence. A 37-year-old male had a 4-week history of oral ulceration. Aphthous stomatitis was initially diagnosed, and was treated with chlorhexidine gluconate. Intraoral examination revealed multiple painful erosion with sloughing on the buccal mucosa, labial mucosa and dorsum of the tongue. Anti-HSV-1 IgG was reactive, while ANA test was not. Histopathology examination r...
Oral pemphigus vulgaris: A case report with direct immunofluorescence study
Journal of Oral and Maxillofacial Pathology, 2016
Pemphigus vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes. The initial clinical manifestation is frequently the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin. The etiology of this disease still remains obscure although the presence of autoantibodies is consistent with an autoimmune disease. These antibodies are targeted against the adhesion proteins of keratinocytes, leading to acantholysis (disruption of spinous layer, leading to intraepidermal clefting) and blister formation. Because only oral lesions are present initially, the chances of misdiagnosing the disease as another condition are increased, leading to inappropriate therapy. In this article, we report a case of PV with only oral manifestations in a 36-year-old male.
Oral pemphigus vulgaris: a case report with review of the literature
Journal of Oral Science, 2008
Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that initially manifests in the form of intraoral lesions, which spread to other mucous membranes and the skin. The etiology of pemphigus vulgaris is still unknown, although the disease has attracted considerable interest. The pemphigus group of diseases is characterized by the production of autoantibodies against intercellular substances and is thus classified as autoimmune diseases. Most patients are initially misdiagnosed and improperly treated for many months or even years. Dental professionals must be sufficiently familiar with the clinical manifestations of pemphigus vulgaris to ensure early diagnosis and treatment, since this in turn determines the prognosis and course of the disease. Here, we report a case of pemphigus vulgaris that was misdiagnosed in its earliest stage.
2020
Background: Pemphigus is a rare group of life-threatening muco-cutaneous autoimmune blistering diseases. Frequently, oral lesions precede the cutaneous ones. Sometimes oral clinical features could be misdiagnosed as aphthous ulcer especially when cutaneous lesion could not be found. Histopathology examination is essential to diagnose any vessicobullous diseases. Case report: A case of 44-year-old man with chief complaint recurrent oral ulceration since two years ago, working diagnosed as suspect tuberculosis cutis orificalis was reported. Histopathological examination showed suprabasilar blisters contained of acantholytic cells. Basillary cells remained attached to the basement membrane and lamina propria, arranged like "thombstonesappearance". Lymphocytes and neutrophills were the main inflammatory cells in dermis. Discussion: Clinically, it may be difficult to differentiate recurrence aphthouslike ulcer as oral pemphigus, especially when oral lesion was the main clinical feature. To make diagnose of pemphigus, histopathological examination is necessary and must be done. In some case when both direct and indirect immunofluorescence could not be performed, immunohistochemistry is one of alternative to determine the autoantibodies that involve in disease. Unfortunately this examination is not available in our department and several studies still ongoing in purpose to replace immunofluorescence with immunohistochemistry.
Revisiting pemphigus vulgaris: A case report and review of literature
International Journal of Case Reports and Images
Introduction: Pemphigus is an autoimmune blistering mucocutaneous disease. Production of auto-antibodies against desmosomal glycoproteins is a characteristic feature of the disease. Oral lesions of pemphigus vulgaris are many a times first sign of the disease and hence it is important for a dentist to be familiar with the clinical appearance, diagnosis, and treatment modalities. Case Report: This report describes a case of pemphigus vulgaris in a female patient who presented with ulcers on the gingiva. On the basis of clinical examination and histopathology, we arrived at a diagnosis of pemphigus vulgaris, which was confirmed by immunofluorescence. Conclusion: If left undiagnosed or untreated pemphigus vulgaris may be fatal. Early diagnosis will aid in appropriate treatment and better outcome of the disease.
Oral Pemphigus Vulgaris: A case report
Journal of Chitwan Medical College, 2020
Pemphigus vulgaris is an autoimmune blistering disease clinically presenting as vesicles, bullae and erosion on the skin and mucous membrane. Histopathologically, it is characterized by acantholysis and supra basilar split. The underlying mechanism causing intra epithelial split in pemphigus vulgaris is binding of IgG autoantibodies to desmoglin 3 which belongs to a transmembrane glycoprotein adhesion molecule. Here we present a case of 27 years old male patient suffering from pemphigus vulgaris. This Case report highlights the importance of detailed case history, thorough clinical examination and appropriate investigation to reach a diagnosis of vesiculobullous lesion.
Oral Pemphigus Vulgaris: A Case Report and Review
Abstract: Pemphigus Vulgaris (PV) is chronic autoimmune mucocutaneous disease that initially manifests as intraoral lesions, which may later spread to skin. Dental professionals must be efficient to recognize the clinical features of pemphigus vulgaris to ensure early diagnosis and treatment, so that it determines the favorable prognosis and course of the disease. This paper reports a case of pemphigus vulgaris and review of literature. Key Words: Pemphigus Vulgaris, Nikolsky’s sign.