Pemphigus vegetans of the oral cavity.
BACKGROUND
Pemphigus vegetans, a variant of pemphigus vulgaris, constitutes a rare form of all pemphigus cases, and oral involvement is common. Two clinical subtypes of pemphigus vegetans exist, characterized initially by flaccid bullae and erosions (Neumann) or pustules (Hallopeau). Both subtypes subsequently develop into hyperpigmented vegetative plaques with pustules and hypertrophic granulation tissue at the periphery.


METHODS
We report three cases of pemphigus vegetans with oral manifestations exclusively. Two patients were male aged 30 and 45 years old, respectively, while one was a 51-year-old female.


CONCLUSIONS
Oral lesions in all cases consisted of erosions and whitish, vegetating plaques. The histopathological characteristics were in all cases identical. The spinous cell layer was characterized by intense acanthosis and by the presence of vesicles between the spinous and basal cell layers. Inside the vesicles exudative elements were observed consisting mainly of eosinophils. In the upper lamina propria severe inflammatory reaction was observed. Streptavidin-biotin immunoperoxidase technique showed in all cases intercellular epithelial deposition of IgG and C3.
Markopoulos
Anastasios K
AK
Department of Oral Medicine & Maxillofacial Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece. anmark@dent.auth.gr
Antoniades
Demetrios Z
DZ
Zaraboukas
Thomas
T
D000328:Adult; D003176:Complement C3 / Q000378:metabolism; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007249:Inflammation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000276:immunology / Q000473:pathology*; D010392:Pemphigus / Q000276:immunology / Q000473:pathology*
D003176:Complement C3; D007074:Immunoglobulin G