Unsuspected involvement of the female genitalia in pemphigus vulgaris

Zosmer, Ariel; Kogan, Sophia; Frumkin, Azriel; Dgani, R.; Lifschitz-Mercer, Beatriz

doi:10.1016/0028-2243(92)90163-s

Cited by 11 publications

(13 citation statements)

References 12 publications

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“…However, a few cases have been cited in which the patients had no evidence of cutaneous or oral mucosal involvement at the time of the cervical smear but later developed full-blown PV. 17,18 Pemhigus localized exclusively to vaginal mucosa has been described in only 1 report. 16 A summary of previously published cases of cervical pemphigus where cervical smear cytology was done is presented in Table I.…”

Section: Discussionmentioning

confidence: 99%

Acantholytic Cells Exfoliated from Pemphigus Vulgaris of the Uterine Cervix

Gupta¹,

Sodhani²,

Jain³

2003

Acta Cytologica

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Section: Discussionmentioning

confidence: 99%

Acantholytic Cells Exfoliated from Pemphigus Vulgaris of the Uterine Cervix

Gupta¹,

Sodhani²,

Jain³

2003

Acta Cytologica

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“…PV-involvement of the uterine cervix has seldom been reported, with fewer than 20 cases described in the literature (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Since dermatologists do not usually perform routine gynaecological examinations, the involvement of this site may be more frequent than suggested by the rare reports.…”

Section: Discussionmentioning

confidence: 58%

Pemphigus Vulgaris of the Uterine Cervix: Misinterpretation of Papanicolaou Smears

Lobo¹,

Sousa²,

Aoki³

et al. 2006

Acta Derm Venereol

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Mucosal itivolvement is a commoti finding in pemphigus vuigaris (PV). especially oral lesions, which precede skin blisters in up to 70% of cases (1). Less frequently, other epithelial tissues that also express desinoglein 3 iiiay be affected, for example, pharynx, larynx, nasal cavity, conjunctiva, anus, petiis, urethra, vagina, vulva and oesophagus. The occurrence of PV lesions involving the cervix uteri has rarely been reporied in the literature. The relevance of the involvement of this site lies in the fact that acantholytic cells in routine cervical smears may lead to false positive diagnoses of cervical neoplasia. CASE REPORTA 22-year-o!d woman first presented to our dennatological department with painful, rounded ulcerations on the oral mucosa, desquamative gingivitis and absence of cutaneous lesions. She had been diagnosed previously and treated for PV five years earlier in another institution, and the patient related that cutaneous lesions were present at that time.Histoiogical examination of the oral mucosa biopsy showed a suprabasal cleavage with acantholysis. Direct immunofluorescence revealed deposition of IgG and C3 in the intercellular spaces of the epithelium. Indirect immunoHuoreseence analysis using normal human foreskin sections as substrate exhibited intraepithelial IgG auto-antibodies at a 1:5120 titre. Auto-antibodies against recoinbinant desmogleins (dsg) I and 3 were detected by enzyme-linked immunosorbent assay (ELISA, MBL, Japan). The patient's serum was strongly positive for anti-dsg 3 (index value: 226; cut-off: 20) and weakly positive for anti-dsg 1 {index value: 28; cut-off: 20).After 2 years of follow-up, she experienced a period of exacerbation of her disease: her oral lesions got worse and a vegetating plaque appeared on the right axilla, which was biopsied and revealed a suprabasal acantholysis. Suprisingly. after a routine gynaecologist consultation, the patient was informed that her Papanicolaou smear was suggestive of cervical cancer. She had no gynaecological symptoms, such as dyspareunia, vaginal bleeding or discharge. The patient was then referred to our gynaecological departiiient and, on colposcopic examination, multiple erosions and a positive Nikolsky sign were noticed on the cervix (Fig. Fig. I. Multiple erosions oii the cervix and the positive Nikolsky sign {arrow).

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“…There are other reports that cervical erosions were noted during colposcopies while the disease was quiescent elsewhere. 3,5,7 Subclinical cervical involvement has also been previously demonstrated with cervical smears, in the absence of cervical or vaginal pemphigus lesions. 6,9,14 In an earlier study of genital involvement, Malik and Ahmed 4 reported genital involvement in PV is rare and vulvar lesions occur more commonly than vaginal lesions.…”

Section: J Am Acad Dermatolmentioning

confidence: 83%

“…1,3,[5][6][7]13 Genital involvement usually occurs when other sites are extensively involved. 13 However, in a prior study, Chan et al reported 2 cases of PV in which the patients initially exhibited …”

Section: Discussionmentioning

confidence: 99%

“…Although previous reports have described PV involving the cervix and uterus, few studies have correlated the exact frequency of genital involvement in PV with cytologic findings and the disease's serologic status. [1][2][3][4][5][6][7][8][9][10][11] The current study was therefore designed to discern the frequency of genital involvement in PV and to determine the association between genital involvement and cervicovaginal Pap smear results, and with the disease's serologic status.…”

mentioning

confidence: 99%

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