Abstract
Pemphigus vulgaris (PV) is a rare chronic autoimmune disease that often originates in the oral mucosa. If left untreated, the disease may involve other parts of the body, leading to a fatal outcome.The detection of PV in a patient with herpetic gingivostomatitis is reported. A 45-year-old woman complainedof a painful oral ulcer. Anti-herpes simplex virus (HSV)-I antibodies in the serum were elevated, and an intraoral biopsy specimen showed ballooning degeneration. Herpetic gingivostomatitis was diagnosed. Smears obtained by scraping the oral mucosa, however, showed the presence of Tzanck cells with no multinucleated epithelial cells. Therefore, an association of PV with HSV was suspected. Bullous lesions later appeared on the skin. A biopsy specimen of the skin lesions showed acantholysis and bullous formation just above the basal layer. Direct immunofluorescence showed deposition of IgG, and the results of indirect serologic examination of PV antibodies were positive. A diagnosis of PV was confirmed.Predonine 40mg/day was administered, and the dose was tapered to 20mg/day after about 3 months. Serum antiepithelial antibodies were negative 2 months later. The patient has been well without recurrence.
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