Pemphigus vulgaris presented with cheilitis.

Area of Science:

• Dermatology
• Autoimmune Diseases
• Oral Medicine

Background:

• Pemphigus vulgaris is an autoimmune blistering disease affecting skin and mucous membranes.
• Oral lesions are common initial manifestations, but isolated lip lesions are rare.
• Distinguishing lip pemphigus vulgaris from conditions like actinic cheilitis is crucial.

Purpose of the Study:

• To report an unusual case of pemphigus vulgaris presenting initially and solely with lower lip lesions.
• To highlight the diagnostic challenges and successful management of this presentation.
• To emphasize that localized pemphigus vulgaris can be treated effectively without systemic corticosteroids.

Main Methods:

• A case report of a 41-year-old woman with persistent lower lip lesions.
• Clinical diagnosis considered actinic cheilitis and erosive lichen planus.
• Histopathological examination confirmed suprabasal acantholysis consistent with pemphigus vulgaris.
• Treatment involved intralesional triamcinolone and oral cellcept.

Main Results:

• Histopathology revealed suprabasal acantholysis, confirming pemphigus vulgaris.
• The patient responded well to intralesional triamcinolone and oral cellcept.
• Complete resolution of lip lesions occurred within two months.
• One-year follow-up showed no relapse or new lesions.

Conclusions:

• Cheilitis can be the initial and exclusive manifestation of pemphigus vulgaris.
• Localized pemphigus vulgaris of the lip can be managed effectively with localized treatment.
• This case underscores the importance of considering pemphigus vulgaris in persistent lip lesions.