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Pemphigus mimicking aphthous stomatitis.
Felice Femiano1, Fernando Gombos, Monica Nunziata
1Stomatology Clinic, Second University of Medicines and Surgery, Via Francseco Girardi 2, S. Antimo, Naples 80029, Italy. femiano@libero.it
Summary
Pemphigus vulgaris (PV) can mimic recurrent aphthous stomatitis (RAS). Diagnosis requires testing for antibodies against desmoglein 3 in adults with atypical oral ulcers.
Area of Science:
- Oral Medicine
- Dermatology
- Immunology
Background:
- Pemphigus vulgaris (PV) is an autoimmune condition.
- PV classically presents with persistent oral ulceration.
- Oral manifestations of PV can be misdiagnosed as aphthous stomatitis.
Purpose of the Study:
- To highlight the diagnostic challenge of pemphigus vulgaris mimicking aphthous stomatitis.
- To present cases of PV misdiagnosed as recurrent aphthous stomatitis (RAS).
Main Methods:
- Histopathology and direct immunofluorescence (DIF) of oral lesions.
- Serological testing for antibodies against epithelial intercellular substance, specifically anti-desmoglein 3 antibodies.
Main Results:
- Five patients from southern Europe presented with oral ulcerations resembling RAS.
- Histology, immunostaining, and antibody assays confirmed PV in these patients.
- Atypical ulceration location and adult onset were noted.
Conclusions:
- Assaying for anti-desmoglein 3 antibodies is recommended for patients with atypical RAS.
- Early diagnosis of PV is crucial to prevent disease progression and complications.
- Differentiating PV from RAS is essential for appropriate patient management.