Abortive aphthous‐like oral lesions: an underreported initial presentation of pemphigus vulgaris

Abstract

PV should be kept in mind as a rare differential diagnosis of transient oral ulcerations. We recommend careful observation of these patients and performing indirect immunofluorescence or desmoglein ELISA and even biopsy in atypical cases, to rule out PV especially in older patients and predisposed ethic groups. To find out the differential aspects of RAS and aphthous-like PV, a cohort study on RAS patients is suggested.

Mucosal manifestations of pemphigus vulgaris in ear, nose, and throat; before and after treatment

“…Interestingly, another recent study has reported aphthouslike lesions in a considerable number of patients with PV as an underreported initial presentation. 18 In a more recent study, Espana et al 12 described ENT findings in 16 patients with PV via ENT endoscopic examination and found pharyngeal, laryngeal, nasal, ear, and oral involvement in 75%, 44%, 38%, 19%, and 94% of patients, respectively. Their results are very similar to our study findings and this might be a result of the use of endoscopic examination in both studies.…”

An unusual presentation of oral pemphigus as transient and self‐limiting lesions

“…This history was significantly related to the late onset of disease (at ≥40 years of age). Although these authors studied transient lesions at the onset of disease, these lesions have also been observed after the disease has been controlled by treatment and usually do not require the dosage of steroids to be increased 3 . We have also noticed this in our practice.…”

“…Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucosa characterized by antibodies directed against desmoglein 3 and, to a lesser extent, desmoglein 1 . Oral lesions represent the initial presentation of PV in 50–70% of cases and may be the sole manifestation 3 . Oral erosions in PV tend not to heal without treatment.…”

“…Oral erosions in PV tend not to heal without treatment. “Transient” lesions, which heal within a few days, are not exceptional at the onset of the disease, although these are rarely reported 3 . These transient lesions may account for the misdiagnosis of recurrent aphthous stomatitis (RAS) or Behçet’s disease.…”

“…Daneshpazhooh et al. 3 assessed 161 PV patients with regard to a history of transient oral lesions and misdiagnosis of RAS or Behçet’s disease at the onset of disease. Thirty‐seven patients (23%) gave a positive history of transient lesions; 95% of these had been misdiagnosed as aphthous.…”