Abstract
A 7-year-old female patient reporting burning and pain in the gingiva for 1 year was seen in the clinic. Medical history was without relevance. The person responsible for the child reported that her father was diagnosed with pemphigus foliaceus. Intraoral examination showed atrophy in the upper and lower gingival mucosa associated with vesicles and ulcerations. The diagnostic hypotheses were pemphigoid mucous membranes and pemphigus vulgaris (PV). Incisional biopsy was performed and the histopathology was inconclusive but suggestive of PV. Topical application of clobetasol propionate (0.05%) was prescribed for the patient, with partial resolution. The patient was referred to a specialized medical center, and direct immunofluorescence testing was performed, which was positive for PV. After the evaluation of G6PD test, the patient started dapsone (50 mg/day) treatment. There is difficulty in the diagnosis of immune-mediated diseases, especially in children, so direct immunofluorescence may be necessary for a conclusive diagnosis.
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