Pemphigus vulgaris: A rare case of gingival involvement

Thakur, Nisha; Rayast, Deepa; Negi, Mayum; Bansal, Shivanjli

doi:10.4103/ccd.ccd_799_18

Cited by 1 publication

(1 citation statement)

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“…The classic presentation of PV involves the oral cavity, with the appearance of painful blisters and erosions on the mucosa, followed by the development of skin lesions. However, PV can also have atypical presentations that may lead to a delayed or missed diagnosis [4][5][6][7][8][9][10][11]. These can be structural (pemphigus vegetans) or anatomic (scalp and nail pemphigus).…”

Section: Gupta Et Al 2003 [7]mentioning

confidence: 99%

Scalp, Oral, and Nail Pemphigus Vulgaris: Clinical Characteristics and a Review of the Literature

Eachus¹,

DeLamielleure²,

Mitha³

et al. 2023

Cureus

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Pemphigus vulgaris (PV) is a rare disease that affects the skin and mucous membranes, causing blistering and erosions. Identifying and effectively managing atypical presentations of pemphigus vulgaris can be challenging due to its rarity. We describe a 32-year-old male patient with a medical history including prediabetes, moderate asthma, hyperlipidemia, coccidioidomycosis, and respiratory infections. He was evaluated via telehealth in the allergy and immunology clinic for uncontrolled asthma. Initially, he complained of a whitish film in the mouth while on treatment with fluticasone and salmeterol. He also noted new vesicular lesions on his scalp and body. When evaluated later in the clinic, he was found to have oral and periungual erosions as well as paronychia. After promptly referring to dermatology, histopathological examination and direct immunofluorescence testing were performed on the patient's lesions, revealing changes consistent with PV. Treatment with prednisone and rituximab resulted in the complete resolution of the patient's bullae and nail deformities over several months. This case highlights the importance of a thorough evaluation of complex medical histories and diagnostic testing in managing asthma and allergy symptoms. It also emphasizes the need for a multidisciplinary approach involving specialists such as immunologists, dermatologists, and infectious disease experts in the diagnosis and management of complex cases.

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