Pemphigus Vulgaris in Adolescence: case report

Department of Pediatric Dentistry

Luthern Medical Center

7/17/2009

Residents Name: Tyler Roberts
Article title: Pemphigus Vulgaris in adolescence: case report
Author: Fabio Ramoa Pires, DDS et al
Journal: Pediatric Dentistry
Volume #, pages: 22: 2, 159-162
Year: September 1999
Major topic: Pemphigus Vulgaris
Type of article: case report
Main purpose: review signs and symptoms of Pemphigus Vulgaris (PV) involving a rare case of adolescence.
Method of research: case review
Key pts and findings:
Pemphigus Vulgaris (PV), an autoimmune disease, is an intraepithelial blistering disease caused by auto antibodies against desmosomal antigens. Recently this antigen was cloned and found to be a member of the cadherin family of molecules.
In fifty percent of patients affected by PV, oral lesions will be the first sign of the disease. At some point ninety percent of patients will manifest these types of symptoms. Other forms of Pemphigus such as foliaceus, erythematosus, and vegetans almost exclusively affect the skin. PV most often affects middle aged adults in their fifties and sixties and tends to predominate in females. However, much like the case report found in this article it can and does show up in adolescents and even children.
This case report presents a 16 year old Brazilian female, diagnosed with PV. The patient reported that 5 months prior to her first visit to the hospital, she noticed painful oral ulcers. These oral lesions were soon followed by erythemetous and coalescent, irregularly shaped ulcers on her back. In addition, bilateral submandibular lymphadenopathy (swelling of the lymph nodes) was present. Her oral lesions were described as atrophic, erosive, desquamative lesions involving buccal mucosa, soft palate, togue, and buccal gingiva. Initially, the patient was started on 40 mg per day of prednisone, this however, was gradually reduced to 5 mg per day. The patient has since been in stable condition with candidiasis as her only side effect to the medication.

Conclusion: Dentist should be aware that oral lesions are frequently the first sign of complaints in patients with Pemphigus Vulgaris. No standard treatment protocol exist in adolescence and children due to its rarity.

Assessment of article: Interesting and insightful