Related Experiment Video
Updated: Jun 4, 2026
Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Ear, nose and throat involvement in patients with pemphigus vulgaris: correlation with severity, phenotype and
M Kavala1, S Altıntaş, E Kocatürk
1Department of Dermatology, Göztepe Training and Research Hospital, Istanbul, Turkey.
Background:
Pemphigus vulgaris (PV) is the most common clinical form of pemphigus that is characterized by easily ruptured or loose bulla formation on skin and/or mucosa. The frequency of the ear, nose and throat involvement of PV is not clearly defined.
Objectives:
To evaluate the frequency of ear, nose and throat (ENT) involvement in patients suffering from PV who had been recently diagnosed or exacerbated under follow up and to determine the association with ENT symptoms, clinical involvement, severity and duration of pemphigus vulgaris.
Materials And Methods:
The study group included a total of 38 PV patients comprising 24 new patients and 14 patients who showed exacerbations while on complete remission or under treatment. All patients were asked about ENT symptoms and endoscopic examination were performed to evaluate the presence of nasal, pharynx, larynx and ear involvement.
Results:
Of the 38 patients, 33 (87%) had active PV lesions on endoscopic evaluation. Twenty-five patients (66%) had lesions on pharynx, twenty-one (55%) on larynx, twenty-nine (76%) on nasal mucosa and four (10%) on the ear mucosa. ENT involvement was not associated with the severity and the clinical involvement of the disease. Pharyngeal and nasal involvement was significantly associated with symptoms, while laryngeal and ear involvement was not found to be significantly associated with symptoms. Nasal and ear involvement was not associated with the duration of the disease while pharyngeal and laryngeal involvement favored newly diagnosed patients.
Conclusions:
Our results revealed that high number of patients with PV may present with active ENT lesions, furthermore patients with ear, nose and throat involvement may be asymptomatic and active lesions may be found in patients without any ENT symptoms. Therefore it should be considered that to understand the real extent of PV involvement, endoscopic ENT evaluation should be performed in patients with or without symptoms.
Insights
Pemphigus vulgaris (PV) frequently affects the ear, nose, and throat (ENT), often without symptoms. Endoscopic evaluation is crucial for assessing the full extent of PV involvement in these areas.
Area of Science:
- Otorhinolaryngology
- Dermatology
- Autoimmune Diseases
Background:
- Pemphigus vulgaris (PV) is a common autoimmune blistering disease affecting skin and mucosa.
- The frequency and characteristics of ear, nose, and throat (ENT) involvement in PV are not well-defined.
Purpose of the Study:
- To determine the prevalence of ENT involvement in recently diagnosed or exacerbated PV patients.
- To correlate ENT involvement with symptoms, clinical presentation, disease severity, and duration.
Main Methods:
- 38 PV patients (24 new, 14 with exacerbations) were evaluated.
- Patients reported ENT symptoms, and endoscopic examinations assessed nasal, pharyngeal, laryngeal, and ear mucosa.
Main Results:
- 87% of patients showed active PV lesions on endoscopic evaluation.
- Pharyngeal (66%), laryngeal (55%), nasal (76%), and ear (10%) mucosa involvement was observed.
- Pharyngeal and nasal involvement correlated with symptoms; laryngeal and ear involvement did not. Pharyngeal and laryngeal involvement were more common in newly diagnosed patients.
Conclusions:
- A significant proportion of PV patients have active ENT lesions, often asymptomatically.
- Endoscopic ENT evaluation is recommended for all PV patients, regardless of symptoms, to ascertain the complete disease extent.
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:27Streptococcal Pharyngitis
01:28Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and key...
01:23Chronic Obstructive Pulmonary Disease II: Emphysema
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...