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Abortive aphthous‐like oral lesions: an underreported initial presentation of pemphigus vulgaris
Author(s) -
Daneshpazhooh M,
ChamsDavatchi C,
Ramezani A,
Moinedin F,
Rezaei Hemami M
Publication year - 2009
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.2008.03007.x
Subject(s) - medicine , pemphigus vulgaris , recurrent aphthous stomatitis , dermatology , differential diagnosis , oral mucosa , presentation (obstetrics) , stomatitis , cohort , biopsy , prednisone , sex organ , disease , oral examination , surgery , pathology , dentistry , biology , oral health , genetics
Background Pemphigus vulgaris (PV) usually presents as non‐healing, painful oral erosions, but transient or aphtha‐like lesions are not exceptional at the very beginning of the disease leading to the common misdiagnosis of recurrent aphthous stomatitis (RAS). We designed this cross‐sectional, questionnaire‐based study to evaluate this underreported yet important presentation of PV. Material and methods One hundred and eighty‐five consecutive PV patients were interviewed and a questionnaire, comprising items related to the natural history of oral lesions, was filled in for each. Fourteen patients who had taken steroids (topical or systemic) before their final diagnosis were excluded. Results Twenty‐three per cent of patients gave a history of transient aphthous‐like lesions; 95% of them were misdiagnosed as aphthae. These lesions were especially reported by patients aged 40 years or older ( P < 0.047). Conclusion 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. Conflicts of interest None declared