Severe herpetic gingivostomatitis associated with pemphigus vulgaris

Pemphigus vulgaris and herpesviruses: is there any relationship?

“…First, there are studies that introduced herpesviruses as a complication of pemphigus or immunosuppressive therapy or causative factor for lesions resistant to treatment. [4][5][6][7][8] Second, there are literatures in which herpesviruses are introduced as a trigger factor prior to the occurrence of pemphigus and have considered the probable etiologic role for herpesviruses in the pathogenesis of this autoimmune disorder. [9][10][11] In 1999, Tufano et al 12 using PCR technique, detected HSV DNA in 50% of peripheral blood mononuclear cells and 71% of skin biopsies in pemphigus patients and with emphasis on results of past studies such as Brice study in 1994 13 on the role of herpesviruses in pathogenesis of erythema multiforme, concluded that herpesviruses can play an essential role in the pathogenesis of at least some of the patients with pemphigus.…”

Coexistence of Pemphigus vulgaris and herpes simplex virus infection in oral mucosa diagnosed by cytology, immunohistochemistry, and polymerase chain reaction

“…11 Concomitantly, the various areas of the body sites, including the esophagus, 12 conjunctiva, 13 uterine cervix, 11 and nipple 14 may develop characteristic cytologic lesions. While the association of Pemphigus vulgaris and HSV infection has been documented by several authors, [15][16][17] there are no reports, to our knowledge, of the cytologic description of Pemphigus associated with HSV infection. The accurate cellular diagnosis of oral lesions depends on a number of features, including cell morphology.…”

Coexistência de pênfigo vulgar e infecção pelo vírus herpes simples na mucosa oral

“…Nesse caso, se houver infecção pelo HSV e não for detectada, pode-se pensar em recidiva das lesões de pênfigo e, dessa forma, até aumentar a dose da medicação imunossupressora. Numa segunda situação, quando o paciente com lesões ativas de pênfigo vulgar apresentar alguma piora do quadro ou dificuldade de tratamento (7,9) . A coexistência de pênfigo vulgar e herpes simples oral foi descrita pela primeira vez por Marton (apud Schulpen et al (14) ), em 1963, e desde então poucos casos foram relatados.…”

“…O mecanismo pelo qual o processo ocorre é controverso. A maioria dos autores acredita que a terapia imunossupressora usada para o tratamento do pênfigo vulgar propiciaria a manifestação de lesões pelo HSV (5,9,15) .…”