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Oesophageal pemphigus vulgaris
H Mobacken1, M Al Karawi, A Mohamed
1Gastroenterology, Dermatology and Pathology Division, Riyadh Armed Forces Hospital, Kingdom of Saudi Arabia.
Dermatologica
|January 1, 1988
Summary
Pemphigus vulgaris rarely affects the esophagus. This case highlights that upper digestive tract pain during steroid treatment may indicate esophageal involvement, requiring endoscopic evaluation and adjusted steroid dosage.
Area of Science:
- Gastroenterology
- Dermatology
- Immunology
Background:
- Pemphigus vulgaris is an autoimmune blistering disease.
- Oesophageal mucosal involvement in pemphigus vulgaris is uncommon.
- Corticosteroid therapy is a mainstay for pemphigus vulgaris management.
Observation:
- A patient with pemphigus vulgaris developed epigastric pain during oral steroid treatment.
- Upper gastrointestinal endoscopy revealed oesophageal ulcerations but normal gastroduodenal mucosa.
- Symptoms resolved with cimetidine and increased corticosteroid dosage.
Findings:
- The patient's symptoms were attributed to acantholytic oesophagitis, a rare manifestation of pemphigus vulgaris.
- Oesophageal involvement necessitates consideration of increased corticosteroid dosage, contrasting with steroid-induced peptic ulcers.
- Upper gastrointestinal endoscopy is crucial for diagnosis.
Implications:
- Clinicians should consider oesophageal pemphigus vulgaris in patients with upper digestive tract pain during corticosteroid therapy.
- Endoscopic evaluation is vital for accurate diagnosis and management.
- Management strategies for oesophageal pemphigus vulgaris differ from those for steroid-induced peptic ulcers.