Pemphigus vulgaris (PV) is a rare but potentially life-threatening autoimmune disease affecting the mucosa and the skin. The disease is caused by circulating antibodies to desmosomes (important adhesion proteins linking cells together). Disruption of these intercellular connections results in a loss of cohesion between cells (acantholysis). The clinical result of this process is the development of multiple blisters that easily rupture, leaving behind painful sloughing eroded areas of mucosa and/or skin. We report a case of severe PV in a 56-year-old man presenting with widespread, painful, eroded mucocutaneous lesions. The severity of the disease demanded a range of medical and surgical specialties to successfully manage the problem. This paper highlights the importance of an early multidisciplinary team approach to improve the outcome of patients suffering with this disease.
Ventriculoperitoneal shunt is a commonly performed procedure. Associated complications have been well described in the literature. This is the first case report of a splenic laceration caused by the distal catheter looping around the spleen, requiring a splenectomy. Careful study of pre-operative imaging is recommended in cases where intraabdominal injury is suspected.
Langerhans cell histiocytosis (formerly known as histiocytosis X) is a rare disease of unknown pathogenesis characterised by a pathological proliferation of immature Langerhan cells (important components of the immune response, functioning as antigen presenting cells). Clinical presentation can range from a solitary lesion of bone to a multisystem life‐threatening disorder. Oral manifestations of Langerhans cell histiocytosis have been reported to be as high as 77%. Dentists may be the first clinicians to see early manifestations of the disease. Failure to recognise and appropriately refer these patients could result in extensive destruction of involved tissue, or delay management of the more serious multiorgan disease. We report a case of localised Langerhans cell histiocytosis in a 47‐year‐old female presenting with a short history of single tooth mobility. The clinical and radiographic evaluation, differential diagnosis and management are reported.
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