title: Pemphigus vegetans-Neumann variant associated with intranasal heroin abuse.
abstract: Pemphigus vegetans is variant of pemphigus vulgaris accounting for 5% of all patients with pemphigus disorders. We describe a case of pemphigus vegetans-Neumann type associated with intranasal heroin abuse, restricted to the modified mucous membranes. The results of routine histology and direct and indirect immunofluorescence studies confirmed the diagnosis. The patient responded to oral prednisone of 40 mg daily for 1 month, followed by reduction to a maintenance dose of 15 mg daily. A complete remission was sustained for 6 months. The relationship between intranasal heroin use and the development of pemphigus vegetans remains uncertain but appears to be an intriguing possibility in this patient.
authors.affiliation: Department of Dermatology, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York 10003, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Downie
authors.forename: D P
authors.initials: DP
authors.lastname: Dicostanzo
authors.forename: S R
authors.initials: SR
authors.lastname: Cohen
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D005260:Female; D003932:Heroin / Q000008:administration & dosage; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D007642:Keratosis / Q000209:etiology / Q000473:pathology; D008047:Lip Diseases / Q000209:etiology / Q000473:pathology; D009059:Mouth Diseases / Q000209:etiology* / Q000473:pathology; D009294:Narcotics / Q000008:administration & dosage; D009668:Nose Diseases / Q000209:etiology* / Q000473:pathology; D010392:Pemphigus / Q000209:etiology* / Q000473:pathology; D014060:Tongue Diseases / Q000209:etiology / Q000473:pathology
chemical_list: D009294:Narcotics; D003932:Heroin