Abbas Zaheer, Safaie Naraghi Zahra, Behrangi Elham
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Vahdate Eslami Square, Vahdate Eslami Avenue, Tehran 11996, Iran.
Department of Dermatology, Rasoul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Case Rep Dermatol Med. 2014;2014:147197. doi: 10.1155/2014/147197. Epub 2014 Sep 25.
Background. Pemphigus vulgaris is an autoimmune blistering disease affecting the mucous membrane and skin. In 50 to 70% of cases, the initial manifestations of pemphigus vulgaris are oral lesions which may be followed by skin lesions. But it is unusual for the disease to present with initial and solitary persistent lower lip lesions without progression to any other location. Main Observations. We report a 41-year-old woman with dry crusted lesions only on the lower lip, clinically resembling actinic cheilitis and erosive lichen planus, but histopathological evaluation showed unexpected results of suprabasal acantholysis and cleft compatible with pemphigus vulgaris. We treated her with intralesional triamcinolone 10 mg/mL for 2 sessions and 2 g cellcept daily. Patient showed excellent response and lesions resolved completely within 2 months. In one-year follow-up, there was no evidence of relapse or any additional lesion on the other sites. Conclusion. Cheilitis may be the initial and sole manifestation of pemphigus vulgaris. Localized and solitary lesions of pemphigus vulgaris can be treated and controlled without systemic corticosteroids.
背景。寻常型天疱疮是一种影响黏膜和皮肤的自身免疫性疱病。在50%至70%的病例中，寻常型天疱疮的初始表现为口腔病变，随后可能出现皮肤病变。但该病以初始且孤立的持续性下唇病变为表现，而无进展至其他部位的情况并不常见。主要观察结果。我们报告一名41岁女性，仅下唇有干燥结痂性病变，临床上类似光化性唇炎和糜烂性扁平苔藓，但组织病理学评估显示出意外结果，即基底上棘层松解和裂隙，符合寻常型天疱疮。我们用10mg/mL曲安奈德进行皮损内注射治疗2个疗程，并每日给予2g骁悉。患者反应良好，病变在2个月内完全消退。在一年的随访中，没有复发迹象或其他部位出现任何额外病变。结论。唇炎可能是寻常型天疱疮的初始且唯一表现。寻常型天疱疮的局限性和孤立性病变无需全身使用糖皮质激素即可得到治疗和控制。
