We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upper lip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, the finding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis with moderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris led us to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. The previously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatory injury

We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upperlip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, thefinding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis withmoderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris ledus to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. Thepreviously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatoryinjury.

Unusual Clinical and Pathological Features in Pemphigus Vulgaris: A Potential Diagnostic Pitfall

CALTABIANO, ROSARIO;MAGRO, Gaetano Giuseppe;PUZZO, Lidia;DE PASQUALE, Rocco
2011

Abstract

We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upperlip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, thefinding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis withmoderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris ledus to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. Thepreviously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatoryinjury.
We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upper lip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, the finding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis with moderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris led us to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. The previously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatory injury
Pemphigus vulgaris -Differential diagnosis, dysplasia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/20.500.11769/8638
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