Korean J Dermatol.  1975 Jun;13(2):131-137.

Pemphigus Vulgaris: Report of two cases

• Kim DH

Abstract

The cause of pemphigus vulgaris is autoimmune. The serum containes antibodies against the intercellular substance of stratified epithelium, as demonstrated by means of immunofluorescent staining. Therefore antigen-antibody reaction takes place in the intercellalar spaces of squamous epithelium and leads to acantholysis. The association of pemphigus with malignant conditions was frequently reported. Thus there is now increasing evidence of an association between malignaney and the production of pemphigus antibodies by a tumor itaelf. By the evidence that pemphigus is autoimmune disease, it is used to treat with corticosteroid and immunosuppressive drugs, such as methotrexate. Very high doses of corticosteroid appear to he necesaary for an adequate control of the disease. Even though large doae repersents an effective treatment of pemphigus vulgaris, side effects from thia form of therapy have heen quite significant. Two cases of pemphigus vulgaris are reported. .First patient, a 33 year-old housewife, with flaccid bullae and rupture to form erosions of 3 months duration especialIy on buccal mueosa and genitlia. Second patient, a 66 year-old female, with above skin lesions of 6 months duration on buccal mucosa and whole body. Clinically and histopathologically their eruptions were consistent with pemphigus vulgaris. Large initial dose of predniaolone was employed in these treatment. These patients were improved with treatment prednisolone. Prednisolone therapy gave rise to a large numbar of side effects of varying degrees of severity, such as iatrogenic diabetea mellitus, oral candidiasis, hypokalemia, and pychosis etc. At admission 57days, first case complained of lower abdominal pain and tenderness. At this point it was found clinically that the mass on vaginal vault is present. Punch biopsy was p rformed and confirmed epidermoid carcinoma poorly differentiated (stage V). Cystoscopy showed tumor mass of cervix with extension to bladder posterior wall. We advised. External radiation therapy for carcinoma for about 5 weeks (5,000 Rads) but hopeless she was discharged. Second. Patient was much improved without recurrence. Side effects of prednisolone were also controlled.

MeSH Terms

Abdominal Pain
Acantholysis
Adult
Aged
Antibodies
Antigen-Antibody Reactions
Autoimmune Diseases
Biopsy
Candidiasis, Oral
Carcinoma, Squamous Cell
Cervix Uteri
Cystoscopy
Epithelium
Female
Humans
Hypokalemia
Methotrexate
Mouth Mucosa
Pemphigus*
Prednisolone
Recurrence
Rupture
Skin
Urinary Bladder
Antibodies
Methotrexate
Prednisolone