title: Erosions on a prolapsed uterine in an old woman: an unusual manifestation of pemphigus vulgaris.
abstract: Vaginal involvement in pemphigus vulgaris has previously been described. In all those cases a pelvic examination was needed to explore the lesions. We describe a patient with pemphigus vulgaris who had pemphigus erosions on a prolapsed uterus (i.e., on the everted surface of vagina). The patient had widespread lesions of pemphigus in other mucosal and cutaneous sites. Biopsy, antibodies against desmoglein 1 and 3, and direct and indirect immunofluorescence were confirming. The erosions on the prolapsed uterus were resistant to treatment; other mucosal and cutaneous lesions responded rapidly to prednisolone and azathioprine. After lowering the dose of prednisolone the patient was referred to a gynecologist for a vaginal hysterectomy. This case was unique because her vaginal lesions could be easily examined and followed.
authors.affiliation: Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ramezani
authors.forename: Narges
authors.initials: N
authors.lastname: Ghandi
authors.forename: Maryam
authors.initials: M
authors.lastname: Akhyani
authors.forename: Maryam
authors.initials: M
authors.lastname: Daneshpazhooh
authors.forename: Zahra S
authors.initials: ZS
authors.lastname: Naraghi
authors.forename: Cheyda
authors.initials: C
authors.lastname: Chams-Davatchi
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000276:immunology; D051183:Desmoglein 1 / Q000276:immunology; D051184:Desmoglein 3 / Q000276:immunology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010392:Pemphigus / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D011239:Prednisolone / Q000627:therapeutic use; D014596:Uterine Prolapse / Q000150:complications* / Q000276:immunology / Q000601:surgery
chemical_list: D001323:Autoantibodies; C495297:DSG1 protein, human; C071894:DSG3 protein, human; D051183:Desmoglein 1; D051184:Desmoglein 3; D007166:Immunosuppressive Agents; D011239:Prednisolone