PEMPHIGUS VULGARIS: A case report and literature review

PEMPHIGUS VULGARIS

Abstract

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.