title: Unusual clinical and pathological features in pemphigus vulgaris: a potential diagnostic pitfall.
abstract: We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upper lip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, the finding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis with moderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris led us to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. The previously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatory injury.
authors.affiliation: Section of Anatomic Pathology, Department G.F. Ingrassia, University of Catania, 95123 Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.forename: Gaetano
authors.initials: G
authors.lastname: Magro
authors.forename: Lidia
authors.initials: L
authors.lastname: Puzzo
authors.forename: Enrico
authors.initials: E
authors.lastname: Vasquez
authors.forename: Rocco
authors.initials: R
authors.lastname: De Pasquale