Diagnosis of Laryngeal Pemphigus Vulgaris Can Be Facilitated Using Advanced Endoscopic Methods.

Lucia Staníková,Martin Formánek,Pavel Hurník,Pavel Komínek,Peter Kántor,Karol Zeleník

doi:10.3390/medicina57070686

Abstract

Background: Isolated laryngeal pemphigus vulgaris (LPV) is rare; however, early diagnosis is crucial in determining its course and prognosis. This paper aims to describe mucosal vascular changes typical for LPV using advanced endoscopic methods, which include Narrow Band Imaging (NBI), IMAGE1-S video-endoscopy and enhanced contact endoscopy (ECE). Materials and Methods: Retrospective analysis of all laryngeal mucosal lesion examined using advanced endoscopic methods during 2018–2020 at tertiary hospital was performed. Results: Videolaryngoscopy examination records of 278 patients with laryngeal mucosal lesions were analyzed; three of them were diagnosed with LPV. Epithelial vascularization of LPV included specific pattern. Intraepithelial papillary capillary loops were symmetrically stratified and were organized into “contour-like lines”. This specific vascularization associated with LPV were different from other laryngeal mucosal pathologies. Conclusions: Using advanced endoscopic methods supports early diagnosis of LPV and accelerate the diagnosis and treatment.

Highlights

Accepted: 4 July 2021Pemphigus comprises a group of autoimmune blistering diseases with skin and mucosal manifestations
Videolaryngoscopyexamination examinationrecords records patients laryngeal mucosal lewere analyzed; of them were diagnosed with sions were analyzed; 3 of them were diagnosed with laryngeal pemphigus vulgaris (LPV) (Figure 1)
Our observations suggest that the mucosal changes visible using advanced endoscopic methods and described above as a

Summary

Introduction

Pemphigus comprises a group of autoimmune blistering diseases with skin and mucosal manifestations. Pemphigus vulgaris (PV) is a mucocutaneous disease that presents as enanthemas and erosions, typically in the oral cavity. Other mucosal surfaces are less frequently involved [1]. Exfoliating blisters are painful, can bleed, and in severe cases, they can lead to rapid weight loss. Pemphigus may have an idiopathic origin, or in some cases may be a drug-induced reaction [2]. In patients with lymphoproliferative disorders (mostly non-Hodgkin lymphoma and chronic lymphocytic leukemia), PV is considered a paraneoplastic manifestation [1]

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