Rare Clinical Manifestation of Pemphigus Vulgaris in Elderly Patient : A Case Report and Brief Review (original) (raw)

Oral ulcer and skin lesions: a tell-tale sign of pemphigus vulgaris

Pediatria i Medycyna Rodzinna

Aim: The aim of this case presentation was to highlight the importance of the awareness of two different coexisting pathologies, as well as emphasise that early diagnosis and prompt management are essential to manage pemphigus vulgaris. Pemphigus vulgaris is a rare, life-threatening autoimmune disease characterised by the presence of blisters on the surface of oral mucosa caused by antibodies against adhesion molecules on the cell surface of keratinocytes. Coexistence with various conditions, notably herpes simplex virus, is noteworthy. Case report: We report a case of a middle-aged female who presented with non-healing oral ulceration that turned out to be herpes simplex virus, consequently triggering pemphigus vulgaris. Histopathology and immunofluorescence were suggestive of pemphigus vulgaris, but immunohistochemistry and polymerase chain reaction were indicative of herpes simplex virus infection. Conclusion: The coexistence of a viral infection with pemphigus vulgaris poses a t...

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.

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

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.

Pemphigus vulgaris: a case-based update

Journal (Canadian Dental Association), 2005

Pemphigus vulgaris (PV) is an autoimmune disease accounting for 80% of all cases of pemphigus. Before the advent of corticosteroid therapy, pemphigus was fatal, with a mortality rate of up to 75% in the first year. It is still a serious disorder, but the 5% to 10% mortality rate is now primarily due to the side effects of therapy. In 75% to 80% of cases, PV lesions first appear in the oral cavity. Dentists are therefore in a unique position to recognize the oral manifestations of the disease, allowing early diagnosis and initiation of treatment. The diagnosis is based on pathological examination and immunofluorescence testing. Systemic corticosteriods and steroid-sparing agents are the mainstays of treatment; topical corticosteroids may also be used to accelerate healing of persistent oral lesions. This article describes a 71-year-old woman with multiple chronic ulcers in the oral cavity, in whom PV was diagnosed 4 months after the symptoms first appeared. The article also reviews t...

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 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.

ORAL PEMPHIGUS - A CASE REPORT

PEMPHIGUS is a serious chronic skin disease characterized by the appearance of vesicles & bullae, small or large fluid filled blisters that develop in cycles. The term pemphigus refers to a group of autoimmune blistering diseases of skin and mucous membranes that are characterized histologically by intraepidermal blisters due to acantholysis and immunopathologically by an in vivo bound & circulating IgG directed against the cell surface of keratinocytes. Pemphigus vulgaris is the most common formand frequently affects oral cavity.Main antigen is Dsg3 (desmoglein) but 50% of patients also have autoantibodies to Dsg 1.Dsg3: Dsg 1 is directly proportional to severity. We present a case of pemphigus occurring in the oral cavity of a 45-year-old male. Treatment with oral prednisolone and topical steroid resulted in remission of the disease. Clinical features, histological features and treatment of pemphigus vulgaris will be discussed. KEYWORDS: Pemphigus, blisters, acantholysis, autoantibodies.