Abstract:
BACKGROUND:Vulvo-cervico-vaginal involvement has rarely been reported in pemphigus vulgaris (PV) and has not been reported in pemphigus foliaceus (PF). OBJECTIVES:We sought to evaluate genital lesions and Papanicolaou (Pap) smears in female patients with PV and PF. METHODS:This prospective study includes all consecutive cases of female patients with PV and PF seen from May 2009 to February 2010. Gynecologic examination was performed and Pap smears were collected for cytologic analysis from each patient. RESULTS:A total of 56 patients were given a diagnosis of pemphigus (41 PV and 15 PF). Genital involvement was observed in 9 patients with PV (22%) and the vulva was the most common genital site of involvement. Of these 9 patients, 8 presented with active skin/mucous lesions. Four of 15 patients with PF had genital lesions and vulva was the exclusive site of involvement. Three of 4 patients with PF and genital involvement also showed active cutaneous lesions. Six of 56 patients (5 PV and 1 PF) presented with atypical squamous cells of undetermined significance in Pap smear analysis. Upon further pathologic review, acantholytic cells were seen, confirming the diagnosis of pemphigus. LIMITATIONS:A small number of PF cases were studied. CONCLUSIONS:Vulvar lesions were the second most frequent site of mucous membrane PV. Herein we report the first case to our knowledge of symptomatic genital lesions in a patient with PF. Moreover, acantholytic cells in Pap smears were found in a patient with PF who was in complete remission off therapy with no clinical genital lesions and no circulating anti-desmoglein-1 and anti-desmoglein-3 autoantibodies. Gynecologic evaluation in patients with pemphigus, including a careful evaluation of Pap smears, should be recommended.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Fairbanks Barbosa ND,de Aguiar LM,Maruta CW,Aoki V,Sotto MN,Labinas GH,Perigo AM,Santi CGdoi
10.1016/j.jaad.2011.10.004subject
Has Abstractpub_date
2012-09-01 00:00:00pages
409-16issue
3eissn
0190-9622issn
1097-6787pii
S0190-9622(11)01088-7journal_volume
67pub_type
杂志文章abstract:INTRODUCTION:Intravenous immunoglobulin (IVIG) is used to treat many inflammatory and autoimmune disorders and although generally well tolerated, cutaneous side effects occur. OBJECTIVE:We reviewed reports of pompholyx and eczematous reactions associated with IVIG. METHODS:A literature search was performed using the ...
journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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