Post-cesarean section pemphigus vegetans in a young woman treated with methylprednisolone and thalidomide

Abstract

Pemphigus vegetans is a rare variant of pemphigus vulgaris. Here, we report a rare case of postparturition pemphigus vegetans in a young woman without any prior medical history. The patient presented with extensive oral mucosal erosion, conjunctivitis, and fingernail dystrophy. A histopathological biopsy taken from the tongue showed pseudoepitheliomatous hyperplasia of the epidermis with eosinophilic spongiosis, and an intraepidermal cleft and direct immunofluorescence showed intercellular immunoglobulin G and complement component C3 deposition. A final diagnosis of pemphigus vegetans was made on the basis of clinical and histopathological features and laboratory findings. Complete remission was achieved by a combination of methylprednisolone and thalidomide. This case report indicates that the occurrence of postparturition pemphigus vegetans is strongly associated with immune status related to hormone levels throughout pregnancy and postparturition. Furthermore, it suggests that a combination of methylprednisolone and thalidomide may be an effective option for pemphigus vegetans treatment.