A rare case of pemphigus vulgaris disguised as a malignant gingival ulcer

Jun Chen; Hui Tang; Ding Zhang; Yuqi Tang; Wenjie Li; Gui Liu; Binjie Liu

doi:10.1186/s12903-023-02980-6

A rare case of pemphigus vulgaris disguised as a malignant gingival ulcer

BMC Oral Health. 2023 May 23;23(1):319. doi: 10.1186/s12903-023-02980-6.

Authors

Jun Chen^#¹, Hui Tang^#¹, Ding Zhang¹, Yuqi Tang¹, Wenjie Li^{1

2}, Gui Liu³, Binjie Liu⁴

Affiliations

¹ Department of Periodontics and Oral Medicine, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxillofacial and Regenerative Medicine, Central South University, Changsha, 410008, China.
² Department of Orthodontics, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, China.
³ Department of Oral Pathology, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, China. 1134755197@qq.com.
⁴ Department of Periodontics and Oral Medicine, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxillofacial and Regenerative Medicine, Central South University, Changsha, 410008, China. liubinjie@188.com.

^# Contributed equally.

Abstract

Background: Pemphigus vulgaris (PV) is a kind of rare and severe autoimmune bullous disease. In this case, the specificity of oral PV lies in the clinical manifestations of a single palatal ulcer, and no blisters were found in the oral mucosa. This case provides a powerful reference for dentists diagnosing and treating oral PV with atypical clinical presentations.

Case presentation: A 54 years old female patient presented with a non-healing palatal gingival ulcer for over three months. By histopathological H&E staining and the direct immunofluorescence (DIF) test, the final diagnosis was oral PV. After topical glucocorticoid therapy, the affected area was cured.

Conclusions: In patients with prolonged erosion of the skin or oral mucosa, even if complete blisters are not visible, the physician should consider autoimmune bullous diseases and pay attention to avoid diagnostic defects.

Keywords: Gingival ulcer; Oral mucosa; Pemphigus vulgaris (PV).

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Female
Gingiva
Gingivitis*
Humans
Middle Aged
Oral Ulcer*
Pemphigus*
Stomatitis*
Ulcer