Erosions on a prolapsed uterine in an old woman: an unusual manifestation of pemphigus vulgaris

Dermatol Online J. 2009 Sep 15;15(9):9.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoantibodies / immunology
  • Desmoglein 1 / immunology
  • Desmoglein 3 / immunology
  • Drug Resistance
  • Female
  • Humans
  • Hysterectomy, Vaginal
  • Immunosuppressive Agents / therapeutic use
  • Pemphigus / complications*
  • Pemphigus / diagnosis
  • Pemphigus / drug therapy
  • Pemphigus / immunology
  • Prednisolone / therapeutic use
  • Uterine Prolapse / complications*
  • Uterine Prolapse / immunology
  • Uterine Prolapse / surgery

Substances

  • Autoantibodies
  • DSG1 protein, human
  • DSG3 protein, human
  • Desmoglein 1
  • Desmoglein 3
  • Immunosuppressive Agents
  • Prednisolone