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OBJECTIVE: This paper reports a case of pemphigus vulgaris (PV) in a young adult male affecting the oral mucosa to highlight the importance of early diagnosis and treatment of this lesion
CASE REPORT: A 33 years old student presented with a six week history of multiple ulcers in the oral cavity. Intra-oral examination revealed multiple irregular shaped ulcers with erythematous floor on the soft palate, buccal mucosa, anterior pillar of fauces, ventral surface of the tongue and floor of the mouth. An initial diagnosis of erythema multiforme was made. Investigations with full blood count, retroviral screening and fasting blood sugar showed normal findings. A definitive diagnosis of pemphigus vulgaris was made following histopathological examination.
The initial treatment administered were Prednisolone tablets 60mg/day for one week, then the dose was stepped down to 40mg daily for a week. Triamcinolone dental paste was applied topically twice daily for 2 weeks. The oral lesion improved drastically and the dose of prednisolone was further stepped down to 20mg daily in 2 weeks. There was an exacerbation of the oral lesions at a dose of 20mg daily of prednisolone, hence the daily dose was adjusted to 60mg daily for 4 weeks at which the oral lesions started improving. The patient has been on maintenance dose of prednisolone of 30 mg/day and Dexamethasone 1 mg dissolved in 10 ml of water as mouth rinse daily for 5 months.
CONCLUSION: This study reported a case of PV involving the oral mucosa found in a young adult male. Early diagnosis and treatment of the oral lesions with local and systemic steroid resulted in remission within 6 months.