Case Report
Volume 19 Issue 5 - 2020
Oral Limited Pemphigus Vulgaris-A Case Report
Maryam Jalili Sadrabad1 and Azra Mohiti2*
1Assistant Professor, Oral Medicine Department, Dental School, Semnan University of Medical Science, Semnan, Iran
2Assistant Professor, Oral Medicine Department, Dental School, Shahid Sadoughi University of Medical Science, Yazd, Iran
*Corresponding Author: Azra Mohiti, Assistant Professor, Oral Medicine Department, Dental School, Shahid Sadoughi University of Medical Science, Yazd, Iran.
Received: March 02, 2020; Published: April 14, 2020




Abstract

Background: Pemphigus vulgaris (PV) is a chronic inflammatory mucocutaneous disease that occurs mostly in the 5 - 6 decade of life and Ashkenazi Jews racial groups. In most cases the disease begins with oral lesions and progresses to other mucosa and skin. Diagnosis of PV includes histopathologic examination of the affected area and confirmation with direct immunofluorescence test (DIF). Now days pemphigus Vulgaris is treated with corticosteroids in combination to other immune suppressor drugs, although consumption of them for long periods of time has its own challenging side effects.

Case Presentation: The patient was a 20-year-old woman who referred to the Oral Medicine Department of Semnan University of Medical Sciences by a dermatologist. Intraoral examinations revealed widespread wound throughout the mouth. The histopathologic report indicates Pemphigus Vulgaris. The patient was instructed to take oral corticosteroid. One month later, the dose of the drug was tapered and no recurrence was observed at the constant maintenance dose for 4 months.

Discussion and Conclusion: As stated PV is an autoimmune disease which are is common in middle age but this patient was only 20 years old which is an uncommon age for PV. It can be debated that in the modern era because of higher stress levels in the society especially women, the incidence of stress related diseases could increase and also the occurrence age could decrease significantly as seen in this case. In our case because there was only oral cavity involvement is seen, low dose of corticosteroids was initiated as treatment in despite of standard high doses. This report showed that low doses of corticosteroids could be used in cases of isolated PV in the oral cavity.

Keywords: Pemphigus Vulgaris; Oral Medicine; Stress

References

  1. Najafi Sh., et al. “Serum level of antioxidants in patients with pemphigus vulgaris”. Orumie University of Medical Sciences Journal 2 (2016): 148-155.
  2. Robinson JC., et al. “Oral pemphigus vulgaris. A review of the literature and a report on the management of 12 cases”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 4 (1997): 349-355.
  3. Greenberg MS and Glick M. “Burket’s oral medicine diagnosis and treatment”. 10th Spain: BC Decker (2003): 68-71.
  4. Neville B., et al. “Color atlas of clinical oral pathology”. 2nd USA: Williams & Wilkins (1999): 446-448.
  5. Karimi A., et al. “Expression of human endogenous retroviruses in pemphigus vulgaris patients”. Molecular Biology Reports 46 (2019): 6181-6186.
  6. Zhou S., et al. “Autoreactive B cell differentiation in diffuse ectopic lymphoid-like structures of inflamed pemphigus lesions”. Journal of Investigative Dermatology 2 (2019): 309-318.
  7. Sajedianfard S., et al. “Family dermatology life quality index in patients with pemphigus vulgaris: A cross-sectional study”. Indian Journal of Dermatology, Venereology and Leprology (2019).
  8. Gholizadeh N., et al. “Pemphigus Vulgaris Associated with Rheumatoid Arthritis in a Patient not Taking Penicillamine”. Journal of Dental Research, Dental Clinics, Dental Prospects 1 (2012): 33-35.
  9. Champion RH., et al. “Text book of dermatology”. 6th USA: Blackwell Science Publications (1998): 1874-1864.
  10. Fashtami L and Heydari Seraj M. “A comparison of DIF, IIF tests in serodiagnosis of Pemphigus vulgaris in 46 patients referred to Razi Hospital during 1997-98”. [Thesis]. Tehran: Razi Hospital, Tehran University of Medical Sciences (1998).
  11. Laskaris G. “Color atlas of oral diseases in children and adolescents”. Germany: Thieme (2000): 160-163.
  12. Melchionda V and Harman K. “Pemphigus vulgaris and pemphigus foliaceus: an overview of the clinical presentation, investigations and management”. Clinical and Experimental Dermatology7 (2019): 740-746.
  13. Gheisari M., et al. “Methylprednisolone pulse therapy plus adjuvant therapy for pemphigus vulgaris: an analysis of 10 years' experience on 312 patients”. Dermatologic Therapy 1 (2019): e13057.
  14. Fortuna G., et al. “The use of Rituximab as adjuvant in the treatment of oral pemphigus vulgaris”. Journal of Oral Pathology and Medicine 1 (2019): 17.
  15. Mignogno MD., et al. “Oral Pemphigus: Long term behavior and clinical response to treatment with deflazacort in sixteen cases”. Journal of Oral Pathology and Medicine 4 (2000): 145-152.
  16. Harman KE., et al. “British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris”. British Journal of Dermatology 5 (2017): 1170-1201.
  17. Ilanlou A. “A statistical evaluation of Pemphigus vulgaris in patients referred to Razi Hospital and department of Oral & Maxillofacial Pathology, Faculty of Dentistry, Tehran University of Medical Sciences during 1997-98”. [Thesis]. Tehran: School of Dentistry, Tehran University of Medical Sciences (1998).
  18. Bystryn JC and Steinman NM. “The adjuvant therapy of pemphigus. An update”. Archives of Dermatology 2 (1996): 203-212.
  19. Sirois DA., et al. “Diagnostic patterns and delays in pemphigus vulgaris: experience with 99 patients”. Archives of Dermatology 12 (2000): 1569-1570.
Citation: Maryam Jalili Sadrabad and Azra Mohiti. “Oral Limited Pemphigus Vulgaris-A Case Report”. EC Dental Science 19.5 (2020): 70-75.

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