PEMPHIGUS VULGARIS (PV)
PEMPHIGUS VULGARIS (PV) (See also Section 6) ICD-10: L10.0
• Often presents in oral mucosa; may be confined to this site for months before cutaneous bullae occur. Mucosal predominant PV shows titers for Desmoglein 3. Mucocutaneous disease more commonly expresses both Desmoglein 1 and 3.
• Findings: Blisters are very fragile, rupture easily, and are rarely seen. Sharply marginated erosions of the mouth (buccal mucosa, hard and soft palate, and gingiva) are presenting symptoms. Gingivitis can be a presenting sign. Erosions are extremely painful, interfering with nutrition (Fig. 33-24).
• Biopsy, immunofluorescence, or antibody titers against Desmoglein 1 or 3 confirm the diagnosis (see “Pemphigus Vulgaris” in Section 6).
FIGURE 33-24 • Pemphigus vulgaris Shallow ulcers and erosions with underlying beefy erythema/dermal tissue are commonly aggravated by trauma from swallowing spicy foods or citrus.