Dermatologic and Oral Manifestations of Pemphigus Vulgaris: A Case Report with Review

Introduction: Pemphigus vulgaris is a chronic, autoimmune, mucocutaneous disorder characterized by a rapid appearance of a thin-walled vesicle and/or bulla, which ruptures eventually, resulting in painful erosions. The global occurrence is 0.1-0.5 cases/1 lakh population/year. Although a higher incidence in women has been reported, many suggest an equal sex predilection. Case description: A 72-year-old male patient reported to our department with painful ulcerations in his mouth and a severe dysphagia for 15 days followed by the appearance of similar lesions in the back, legs, and genital areas. The ulcerations were extremely tender, superficial, and ragged, showing a positive Nikolsky's sign. A provisional diagnosis of the vesiculobullous disease was made. A cytological smear, a routine histopathological examination, and a direct immunofluorescence test confirmed the diagnosis as pemphigus vulgaris. Management and prognosis: The patient was on corticosteroids in tapering doses along with azathioprine and antibiotics. By 6 weeks, the lesions had healed and no recurrence was noted afterwards. Conclusion: Pemphigus vulgaris is a serious disease that can turn lethal if early diagnosis and immediate treatment are not provided. Systemic corticosteroids remain the mainstay of treatment, which markedly reduces the clinical course with a favorable outcome.