Pemphigus vulgaris: a case report

Abstract

Pemphigus vulgaris (PV) is an autoimmune mucocutaneous disorder of the oral cavity and is the most common subtype of pemphigus. The etiology remains obscure, although the disease is characterized by autoantibodies directed against the desmoglein component of the keratinocytes. It manifests clinically as vesicle, bullae or erosions of skin and mucous membrane and histopathologically shows the presence of acantholysis. The presence of exclusive oral lesions initially increases the chances of misdiagnosing the disease as another condition, posing diagnostic, therapeutic and prognostic difficulties, consequently prompt diagnosis and treatment can prevent untoward consequences. Demonstration of IgG antibodies against desmoglein in Immunofluroscence confirms the diagnosis. In here we report a case of a 55-year-old female patient suffering from PV emphasizing the significance of clinical examination, pertinent investigations, treatment rendered and its outcome.

Keywords: Pemphigus vulgaris; acantholysis; autoimmune disorder; case report; corticosteroids.

Figure 1

series of pictures showing irregular ulcerations and encrustations on lips and upper and lower labial mucosa, bilateral buccal mucosa, dorsal and ventral surfaces of the tongue

Figure 2

H and E sections showing hyperplastic parakeratinized stratified squamous epithelium with broad elongated retepegs, the superficial epithelium shows intercellular edema, ulceration with suprabasillar split, and separation of parabasal layer of the epithelium

Figure 3

complete regression of lesions on lips and upper and lower labial mucosa, bilateral buccal mucosa, dorsal and ventral surfaces of the tongue