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Case Reports
. 2021 Sep 15;13(9):e18005.
doi: 10.7759/cureus.18005. eCollection 2021 Sep.

Oral Pemphigus Vulgaris

K Subadra  1 , Sathasivasubramanian S  1 , Aravind Warrier S  1
Affiliations
Case Reports

Oral Pemphigus Vulgaris

K Subadra et al. Cureus. .

Abstract

Pemphigus is a chronic mucocutaneous autoimmune disease with the clinical feature of blisters that initially appear in the oral cavity and later in the skin. The dental professionals play an important role in diagnosing the disease. Early diagnosis and treatment determine the course and prognosis of the disease. Systemic corticosteroids continue to be the standard therapy for pemphigus vulgaris (PV). Management of PV involves prolonged use of steroids to control the disease and prevent relapses, but associated adverse events constantly remain a great challenge. Regular periodic clinical evaluation of patients with pemphigus on steroids is mandatory. This article describes a case of a 50-year-old woman with multiple chronic ulcers in the oral cavity in whom the diagnosis of PV was made and treated. The case study is followed by a review of the literature including etiology, pathogenesis, clinical features, as well as the various diagnostic criteria and the therapeutic options of PV.

Keywords: bullae; desmoglein; mycophenolate mofetil; pemphigus vulgaris; triamcinolone acetonide; tzanck test.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Multiple shallow ulcers with erythematous halo and tissue tags in the right (A) and left (B) buccal mucosa; soft palate (C) and lower labial mucosa (D).
Figure 2
Figure 2. Ruptured bullae in the right (A) and left (B) lateral border of the tongue.
Figure 3
Figure 3. Ventral surface of the tongue.
Multiple ruptured bullae with erythematous halo in the ventral surface of the tongue.
Figure 4
Figure 4. Tzanck smear.
Smear reveals acantholytic cells
Figure 5
Figure 5. Incisional biopsy.
Low-power photomicrograph shows intraepithelial cleft and underlying connective tissue with chronic inflammatory cells (hematoxylin-eosin 10x).
Figure 6
Figure 6. Completely healed lesions in right (A) and left (B) buccal mucosa; soft palate (C) and lower labial mucosa (D).
Figure 7
Figure 7. Completely healed lesions in right (A) and left (B) lateral border of the tongue.
Figure 8
Figure 8. Ventral surface of the tongue.
Completely healed lesions.
See this image and copyright information in PMC

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