Mucosal manifestations of pemphigus vulgaris in ear, nose, and throat; before and after treatment.
BACKGROUND
Pemphigus vulgaris (PV) is a life-threatening autoimmune bullous disease, mediated by autoantibodies directed against antigens on the keratinocyte cell surface of stratified squamous epithelia. The frequency of ear, nose, and throat (ENT) involvement in PV is not clearly identified.


OBJECTIVE
We sought to evaluate the ENT involvement in new patients with PV examined by ENT endoscopy before and after treatment.


METHODS
This study included 41 new patients with PV. All patients were evaluated for ENT manifestations by otoscopic and endoscopic examination before treatment. After these examinations, the patients received proper treatment according to standard protocols. Thirty patients were re-evaluated by endoscopic examination after clinical remission of mucocutaneous signs.


RESULTS
A total of 41 (33 [80.5%] male and 8 [19.5%] female) patients with mean age of 44.56 ± 12.76 years entered this study. In ENT examination of patients before the treatment, 11 (26.8%) patients showed ear, 15 (36.6%) nasal, 37 (90.3%) oral, 25 (61%) pharyngeal, and 24 (58.5%) laryngeal involvement. Thirty patients underwent the posttreatment ENT examination. We found ear signs in 2 (6.7%), nasal involvement in 1 (3.3%), oral signs in 4 (13.3%), pharyngeal manifestations in 6 (20%), and laryngeal signs in 3 (10%) patients after treatment. The treatment was significantly effective in the improvement of mucosal lesion in different sites (P < .01).


CONCLUSIONS
Eleven patients refused to undergo posttreatment ENT examination.


CONCLUSIONS
ENT evaluation may be worthwhile to evaluate the disease extension in patients with PV more definitely and exclude other potential etiologies in recalcitrant patients.
Skin Research Center, Shahid Beheshti University of Medical Sciences, Shohada-e Tajrish Hospital, Tehran, Iran. rmrobati@gmail.com
Reza Mahmoud
RM
Robati
Mohammad
M
Rahmati-Roodsari
Peyman
P
Dabir-Moghaddam
Ali
A
Farnaghi
Farshid
F
Mahboobi-rad
Hoda
H
Rahimi
Parviz
P
Toossi
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009092:Mucous Membrane; D010038:Otorhinolaryngologic Diseases / Q000209:etiology*; D010392:Pemphigus / Q000150:complications* / Q000628:therapy*; D011446:Prospective Studies