Case Report
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Year 2023, Volume: 9 Issue: 2, 93 - 99, 31.08.2023

Abstract

References

  • 1. Ruocco E, Baroni A, Wolf R, Ruocco V. Life-threatening bullous dermatoses: Pemphigus vulgaris. Clin Dermatol. 2005 May-Jun ve 15896536., 23(3):223-6. doi: 10.1016/j.clindermatol.2004.06.015. PMID:. Ruocco.
  • 2. Kasperkiewicz M, Ellebrecht CT, Takahashi H, Yamagami J, Zillikens D, Payne AS, Amagai M. Pemphigus. Nat Rev Dis Primers. 2017 May 11, 28492232, 3:17026. doi: 10.1038/nrdp.2017.26. PMID: ve PMC5901732., PMCID:.
  • 3. Arpita R, Monica A, Venkatesh N, Atul S, Varun M. Oral Pemphigus Vulgaris: Case Report. Ethiop J Health Sci. 2015 Oct, 26949302, 25(4):367-72. PMID: ve PMC4762976., PMCID:.
  • 4. Odom RB, James WD, Berger TG. Andrew’s Diseases of the Skin. 9th Ed, Philadelphia: WB Saunders Company 2000:574-605.
  • 5. Uzun S, Durdu M, Akman A, et al. Pemphigus in the Mediterranean region of Turkey: A study of 148 cases. Int J Dermatol 2006 ve 45(4):523-8.
  • 6. Alpsoy E, Akman-Karakas A, Uzun S. Geographic variations in epidemiology of two autoimmune bullous diseases: pemphigus and bullous pemphigoid. Arch Dermatol Res. 2015 May ve 25589418., 307(4):291-8. doi: 10.1007/s00403-014-1531-1. Epub 2015 Jan 15. PMID:.
  • 7. Kridin K, Schmidt E. Epidemiology of Pemphigus. JID Innov. 2021 Feb 20, 34909708, 1(1):100004. doi: 10.1016/j.xjidi.2021.100004. PMID: ve PMC8659392., PMCID: . 8. Hübner F, König IR, Holtsche MM, Zillikens D, Linder R, Schmidt E. Prevalence and age distribution of pemphigus and pemphigoid diseases among paediatric patients in Germany. J Eur Acad Dermatol Venereol. 2020 Nov ve 10.1111/jdv.16467., 34(11):2600-2605. doi:.
  • 9. 2011, Sinha AA. The genetics of pemphigus. Dermatol Clin. ve 29:381–391.
  • 10. Nousari HC, Anhalt GJ. Pemphigus and bullous pemphigoid. Lancet. 1999 ve 354(9179):667–672.
  • 11. Pisanti, S. S. Y. K. E., et al. "Pemphigus vulgaris: incidence in Jews of different ethnic groups, according to age, sex, and initial lesion." Oral Surgery, Oral Medicine, Oral Pathology 38.3 (1974): 382-387.
  • 12. Chams‐Davatchi, Cheyda, et al. "Pemphigus: analysis of 1209 cases." International journal of dermatology 44.6 (2005): 470-476.
  • 13. Simon, David G., et al. "Pemphigus in Hartford county, Connecticut, from 1972 to 1977." Archives of Dermatology 116.9 (1980): 1035-1037.
  • 14. Hübner F, Recke A, Zillikens D, Linder R, Schmidt E. Prevalence and Age Distribution of Pemphigus and Pemphigoid Diseases in Germany. J Invest Dermatol. 2016 Dec ve 27456755., 136(12):2495-2498. doi: 10.1016/j.jid.2016.07.013. Epub 2016 Jul 25. PMID:.
  • 15. Yoshida, Kazue, et al. "Cutaneous type pemphigus vulgaris: a rare clinical phenotype of pemphigus." Journal of the American Academy of Dermatology 52.5 (2005): 839-845.
  • 16. Saccucci, M., Di Carlo, G., Bossù, M., Giovarruscio, F., Salucci, A., & Polimeni, A. (2018). Autoimmune Diseases and Their Manifestations on Oral Cavity: Diagnosis and Clinical Management. Journal of Immunology Research, 2018, 1–6. Doi:10.1155/2018/606.
  • 17. Schmidt E, Kasperkiewicz M, Joly P. Pemphigus. Lancet. 2019 Sep 7 ve 31498102., 394(10201):882-894. doi: 10.1016/S0140-6736(19)31778-7. PMID:.
  • 18. Bulut E, Otoimmün Hastalığı Olan ve İmmünsüpresif Tedavi Gören Hastalarda Diş Hekimi Yaklaşımı., Türkiye Klinikleri Diş Hekimliği Bilimleri Dergisi, 1 / 2015.
  • 19. Batistella EÂ, Sabino da Silva R, Rivero ERC, Silva CAB. Prevalence of oral mucosal lesions in patients with pemphigus vulgaris: A systematic review and meta-analysis. J Oral Pathol Med. 2021 Sep ve PM, 50(8):750-757. doi: 10.1111/jop.13167. Epub 2021 Apr.
  • 20. Shamim T, Varghese VI, Shameena PM, Sudha S. Pemphigus vulgaris in oral cavity: clinical analysis of 71 cases. Med Oral Patol Oral Cir Bucal. 2008 Oct 1 ve 18830168., 13(10):E622-6. PMID:.
  • 21. Suliman NM, Åstrøm AN, Ali RW, Salman H, Johannessen AC. Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan. BMC Oral Health. 2013 Nov 21 ve 10.1186/1472-6831-13, 13:66.
  • 22. Boy Z, Ünür M, Kayhan K B, Gingivada Pemfigus Vulgaris'in Erken Lezyonları: Olgu Sunumu, Journal of Istanbul University Faculty of Dentistry, Yıl 2006, Cilt 40, Sayı 3-4, 37 - 42.
  • 23. Stanley JR. Pemphigus. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, Eds. Fitzpatrick’s Dermatology in General Medicine. 6th Ed, New York: McGraw-Hill Company 2003:558-67.
  • 24. Bascones-Martinez A, Munoz-Corcuera M, Bascones-Ilundain C, Esparza-Gómez G (2010) Oral Manifestations of Pemphigus Vulgaris:Clinical Presentation, Differential Diagnosis and Management. J Clin Exp Dermatol Res 1:112. doi:10.4172/2155-9554.1000112 (PDF).
  • 25. He W, Li K, Hu X, Hua H, Wei P. Direct immunofluorescence analysis of oral Tzanck smears for pemphigus vulgaris: A diagnostic test. J Oral Pathol Med. 2021 Nov ve 34536966., 50(10):1050-1056. doi: 10.1111/jop.13239. Epub 2021 Oct 11. PMID:. 13. Bystryn,.
  • 26. Uçmak, D. (2011). Pemfigus. Journal of Clinical and Experimental Investigations, 2(4), 468-473.
  • 27. Anhalt, G. J., Labib, R. S., Voorhees, J. J., Beals, T. F., & Diaz, L. A. (1982). Induction of Pemphigus in Neonatal Mice by Passive Transfer of IgG from Patients with the Disease. New England Journal of Medicine, 306(20), 1189–1196. doi:10.1056/nejm19820.
  • 28. Bystryn, J.-C., & Rudolph, J. L. (2005). Pemphigus. The Lancet, 366(9479), 61–73. doi:10.1016/s0140-6736(05)66829-8 .
  • 29. Giannetti L, Generali L, Bertoldi C. Oral pemphigus. G Ital Dermatol Venereol. 2018 Jun ve 29512980., 153(3):383-388. doi: 10.23736/S0392-0488.18.05887-X. Epub 2018 Mar 6. PMID:.
  • 30. Lever WF, Schaumburg-Lever G. Immunosuppressants and prednisone in pemphigus vulgaris: therapeutic results obtained in 63 patients between 1961 and 1975. Arch Dermatol. 1977 Sep ve 900969., 113(9):1236-41. PMID:.
  • 31. Cholera M, Chainani-Wu N. Management of Pemphigus Vulgaris. Adv Ther. 2016 Jun, 27287854, 33(6):910-58. doi: 10.1007/s12325-016-0343-4. Epub 2016 Jun 10. PMID: ve PMC4920839., PMCID:.
  • 32. Robinson JC, Lozada-Nur F, Frieden I. Oral pemphigus vulgaris: a review of the literature and a report on the management of 12 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Oct ve 934749, 84(4):349-55. doi: 10.1016/s1079-2104(97)90030-5.
  • 33. Sampson V, Kamona N, Sampson A. Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? British Dental Journal 2020, Volume 228: 971-975.
  • 34. Mahmoudi, Hamidreza, et al. "Characteristics and outcomes of COVID-19 in patients with autoimmune bullous diseases: a retrospective cohort study." Journal of the American Academy of Dermatology 84.4 (2021): 1098-1100.
  • 35. Kasperkiewicz, Michael. "COVID-19 outbreak and autoimmune bullous diseases: a systematic review of published cases." Journal of the American Academy of Dermatology 84.2 (2021): 563-568.
  • 36. Scully, Paes De Almeıda, Porter, & Gılkes. (1999). Pemphigus vulgaris: the manifestations and long-term management of 55 patients with oral lesions. British Journal of Dermatology, 140(1), 84–89. doi:10.1046/j.1365-2133.1999.02612.x.
  • 37. Marcelo H. Grunwald M.D., Ilan Katz M.D., Rachel Friedman-Birnbaum M.D.
  • 38. Hale, E. K., & Bystryn, J.-C. (1999). Atypical herpes simplex can mimic a flare of disease activity in patients with pemphigus vulgaris. Journal of the European Academy of Dermatology and Venereology, 13(3), 221–223. doi:10.1111/j.1468-3083.1999.tb00888.x.

COVID-19 İLE İLİŞKİLİ PEMFİGUS VULGARİS: BİR OLGU NEDENİYLE PEMFİGUS VULGARİS

Year 2023, Volume: 9 Issue: 2, 93 - 99, 31.08.2023

Abstract

Pemfigus vulgaris (PV), intraepitelyal kabarcık oluşumu ile karakterize, yaşamı tehdit eden, otoimmün mukokutanöz vezikülobüllöz bir hastalık olan Pemfigusun en sık görülen tipidir. Bu olgu sunumunda amaç başlangıç lezyonları çoğunlukla oral mukozada gözlenen Pemfigus vulgarisin COVID-19 ile ilişkili olduğunu düşündüğümüz olgunun klinik özelliklerini sunmaktır.
40 yaşında erkek hasta kliniğimize dişetlerinde ve yanağındaki ağrılı lezyonları, ağız içinde yaygın yanma ve kaşıntı, yemek yemede zorluk çekmesi şikayetleri ile başvurmuştur. İntraoral muayenesinde sağ taraf bukkal mukozada ve retromolar bölgesinden yumuşak damağına doğru etrafı kırmızı, oval şekilde beyaz-sarı renk multipl lezyonlar gözlenmiştir. Hastaya oral mukozada yaygın olan yanma ve kaşıntı şikayetleri üzerine oral kandidiyazis ön tanısı ile antifungal ilaç tedavisi başlanmıştır ve biyopsi alınması için randevu verilmiştir. COVID-19 testi pozitif çıktığı için randevusuna gelemeyen hasta, iyileştikten sonra geldiğinde; ağzındaki lezyonların çok şiddetlendiği, burnunun içinde yaralar çıktığı, gözlerinin acıdığı, nefes almada güçlük çektiği öğrenilmiştir. Yapılan muayenede tüm oral mukozada eroziv, ülsere, kanamalı lezyonlar gözlenmiştir.
Pemfigus vulgaris ön tanısı konulan hastaya yapılan biyopsi ile tanısı doğrulanmıştır. Bu arada kütanöz lezyonları da oluşan hastaya dermatoloji kliniğinde yoğun sistemik kortikosteroid tedavisine başlanmıştır. Tedavi sonucunda hastanın mukokütanöz lezyonları tam olarak iyileşmiştir. Ancak hasta halen günde 4 mg oral kortikosteroid ile tedavi edilmektedir ve kontrolümüz altındadır.
Pemfigus vulgaris, yaşamı tehdit eden, otoimmün mukokutanöz vezikülobüllöz bir hastalıktır. Başlangıç lezyonları çoğunlukla oral mukozada ve farklı klinik görünümlerde karşımıza çıkmaktadır. Olgumuzda COVID-19 sonrası Pemfigus vulgaris mukozal lezyonlarının şiddetlendiği ve kütanöz lezyona geçişin hızlandığı gözlenmiştir. Yapılan sistemik kortikosteroid tedavisi sonrası oral mukozal lezyonları tam olarak iyileşen hasta hala kontrolümüz altındadır.

References

  • 1. Ruocco E, Baroni A, Wolf R, Ruocco V. Life-threatening bullous dermatoses: Pemphigus vulgaris. Clin Dermatol. 2005 May-Jun ve 15896536., 23(3):223-6. doi: 10.1016/j.clindermatol.2004.06.015. PMID:. Ruocco.
  • 2. Kasperkiewicz M, Ellebrecht CT, Takahashi H, Yamagami J, Zillikens D, Payne AS, Amagai M. Pemphigus. Nat Rev Dis Primers. 2017 May 11, 28492232, 3:17026. doi: 10.1038/nrdp.2017.26. PMID: ve PMC5901732., PMCID:.
  • 3. Arpita R, Monica A, Venkatesh N, Atul S, Varun M. Oral Pemphigus Vulgaris: Case Report. Ethiop J Health Sci. 2015 Oct, 26949302, 25(4):367-72. PMID: ve PMC4762976., PMCID:.
  • 4. Odom RB, James WD, Berger TG. Andrew’s Diseases of the Skin. 9th Ed, Philadelphia: WB Saunders Company 2000:574-605.
  • 5. Uzun S, Durdu M, Akman A, et al. Pemphigus in the Mediterranean region of Turkey: A study of 148 cases. Int J Dermatol 2006 ve 45(4):523-8.
  • 6. Alpsoy E, Akman-Karakas A, Uzun S. Geographic variations in epidemiology of two autoimmune bullous diseases: pemphigus and bullous pemphigoid. Arch Dermatol Res. 2015 May ve 25589418., 307(4):291-8. doi: 10.1007/s00403-014-1531-1. Epub 2015 Jan 15. PMID:.
  • 7. Kridin K, Schmidt E. Epidemiology of Pemphigus. JID Innov. 2021 Feb 20, 34909708, 1(1):100004. doi: 10.1016/j.xjidi.2021.100004. PMID: ve PMC8659392., PMCID: . 8. Hübner F, König IR, Holtsche MM, Zillikens D, Linder R, Schmidt E. Prevalence and age distribution of pemphigus and pemphigoid diseases among paediatric patients in Germany. J Eur Acad Dermatol Venereol. 2020 Nov ve 10.1111/jdv.16467., 34(11):2600-2605. doi:.
  • 9. 2011, Sinha AA. The genetics of pemphigus. Dermatol Clin. ve 29:381–391.
  • 10. Nousari HC, Anhalt GJ. Pemphigus and bullous pemphigoid. Lancet. 1999 ve 354(9179):667–672.
  • 11. Pisanti, S. S. Y. K. E., et al. "Pemphigus vulgaris: incidence in Jews of different ethnic groups, according to age, sex, and initial lesion." Oral Surgery, Oral Medicine, Oral Pathology 38.3 (1974): 382-387.
  • 12. Chams‐Davatchi, Cheyda, et al. "Pemphigus: analysis of 1209 cases." International journal of dermatology 44.6 (2005): 470-476.
  • 13. Simon, David G., et al. "Pemphigus in Hartford county, Connecticut, from 1972 to 1977." Archives of Dermatology 116.9 (1980): 1035-1037.
  • 14. Hübner F, Recke A, Zillikens D, Linder R, Schmidt E. Prevalence and Age Distribution of Pemphigus and Pemphigoid Diseases in Germany. J Invest Dermatol. 2016 Dec ve 27456755., 136(12):2495-2498. doi: 10.1016/j.jid.2016.07.013. Epub 2016 Jul 25. PMID:.
  • 15. Yoshida, Kazue, et al. "Cutaneous type pemphigus vulgaris: a rare clinical phenotype of pemphigus." Journal of the American Academy of Dermatology 52.5 (2005): 839-845.
  • 16. Saccucci, M., Di Carlo, G., Bossù, M., Giovarruscio, F., Salucci, A., & Polimeni, A. (2018). Autoimmune Diseases and Their Manifestations on Oral Cavity: Diagnosis and Clinical Management. Journal of Immunology Research, 2018, 1–6. Doi:10.1155/2018/606.
  • 17. Schmidt E, Kasperkiewicz M, Joly P. Pemphigus. Lancet. 2019 Sep 7 ve 31498102., 394(10201):882-894. doi: 10.1016/S0140-6736(19)31778-7. PMID:.
  • 18. Bulut E, Otoimmün Hastalığı Olan ve İmmünsüpresif Tedavi Gören Hastalarda Diş Hekimi Yaklaşımı., Türkiye Klinikleri Diş Hekimliği Bilimleri Dergisi, 1 / 2015.
  • 19. Batistella EÂ, Sabino da Silva R, Rivero ERC, Silva CAB. Prevalence of oral mucosal lesions in patients with pemphigus vulgaris: A systematic review and meta-analysis. J Oral Pathol Med. 2021 Sep ve PM, 50(8):750-757. doi: 10.1111/jop.13167. Epub 2021 Apr.
  • 20. Shamim T, Varghese VI, Shameena PM, Sudha S. Pemphigus vulgaris in oral cavity: clinical analysis of 71 cases. Med Oral Patol Oral Cir Bucal. 2008 Oct 1 ve 18830168., 13(10):E622-6. PMID:.
  • 21. Suliman NM, Åstrøm AN, Ali RW, Salman H, Johannessen AC. Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan. BMC Oral Health. 2013 Nov 21 ve 10.1186/1472-6831-13, 13:66.
  • 22. Boy Z, Ünür M, Kayhan K B, Gingivada Pemfigus Vulgaris'in Erken Lezyonları: Olgu Sunumu, Journal of Istanbul University Faculty of Dentistry, Yıl 2006, Cilt 40, Sayı 3-4, 37 - 42.
  • 23. Stanley JR. Pemphigus. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, Eds. Fitzpatrick’s Dermatology in General Medicine. 6th Ed, New York: McGraw-Hill Company 2003:558-67.
  • 24. Bascones-Martinez A, Munoz-Corcuera M, Bascones-Ilundain C, Esparza-Gómez G (2010) Oral Manifestations of Pemphigus Vulgaris:Clinical Presentation, Differential Diagnosis and Management. J Clin Exp Dermatol Res 1:112. doi:10.4172/2155-9554.1000112 (PDF).
  • 25. He W, Li K, Hu X, Hua H, Wei P. Direct immunofluorescence analysis of oral Tzanck smears for pemphigus vulgaris: A diagnostic test. J Oral Pathol Med. 2021 Nov ve 34536966., 50(10):1050-1056. doi: 10.1111/jop.13239. Epub 2021 Oct 11. PMID:. 13. Bystryn,.
  • 26. Uçmak, D. (2011). Pemfigus. Journal of Clinical and Experimental Investigations, 2(4), 468-473.
  • 27. Anhalt, G. J., Labib, R. S., Voorhees, J. J., Beals, T. F., & Diaz, L. A. (1982). Induction of Pemphigus in Neonatal Mice by Passive Transfer of IgG from Patients with the Disease. New England Journal of Medicine, 306(20), 1189–1196. doi:10.1056/nejm19820.
  • 28. Bystryn, J.-C., & Rudolph, J. L. (2005). Pemphigus. The Lancet, 366(9479), 61–73. doi:10.1016/s0140-6736(05)66829-8 .
  • 29. Giannetti L, Generali L, Bertoldi C. Oral pemphigus. G Ital Dermatol Venereol. 2018 Jun ve 29512980., 153(3):383-388. doi: 10.23736/S0392-0488.18.05887-X. Epub 2018 Mar 6. PMID:.
  • 30. Lever WF, Schaumburg-Lever G. Immunosuppressants and prednisone in pemphigus vulgaris: therapeutic results obtained in 63 patients between 1961 and 1975. Arch Dermatol. 1977 Sep ve 900969., 113(9):1236-41. PMID:.
  • 31. Cholera M, Chainani-Wu N. Management of Pemphigus Vulgaris. Adv Ther. 2016 Jun, 27287854, 33(6):910-58. doi: 10.1007/s12325-016-0343-4. Epub 2016 Jun 10. PMID: ve PMC4920839., PMCID:.
  • 32. Robinson JC, Lozada-Nur F, Frieden I. Oral pemphigus vulgaris: a review of the literature and a report on the management of 12 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Oct ve 934749, 84(4):349-55. doi: 10.1016/s1079-2104(97)90030-5.
  • 33. Sampson V, Kamona N, Sampson A. Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? British Dental Journal 2020, Volume 228: 971-975.
  • 34. Mahmoudi, Hamidreza, et al. "Characteristics and outcomes of COVID-19 in patients with autoimmune bullous diseases: a retrospective cohort study." Journal of the American Academy of Dermatology 84.4 (2021): 1098-1100.
  • 35. Kasperkiewicz, Michael. "COVID-19 outbreak and autoimmune bullous diseases: a systematic review of published cases." Journal of the American Academy of Dermatology 84.2 (2021): 563-568.
  • 36. Scully, Paes De Almeıda, Porter, & Gılkes. (1999). Pemphigus vulgaris: the manifestations and long-term management of 55 patients with oral lesions. British Journal of Dermatology, 140(1), 84–89. doi:10.1046/j.1365-2133.1999.02612.x.
  • 37. Marcelo H. Grunwald M.D., Ilan Katz M.D., Rachel Friedman-Birnbaum M.D.
  • 38. Hale, E. K., & Bystryn, J.-C. (1999). Atypical herpes simplex can mimic a flare of disease activity in patients with pemphigus vulgaris. Journal of the European Academy of Dermatology and Venereology, 13(3), 221–223. doi:10.1111/j.1468-3083.1999.tb00888.x.
There are 37 citations in total.

Details

Primary Language Turkish
Subjects Oral and Maxillofacial Surgery, Health Care Administration
Journal Section Case Report
Authors

Mahide Büşra Başkan This is me 0000-0003-1217-5361

Meltem Koray 0000-0002-8620-9504

Publication Date August 31, 2023
Submission Date January 6, 2023
Published in Issue Year 2023 Volume: 9 Issue: 2

Cite

Vancouver Başkan MB, Koray M. COVID-19 İLE İLİŞKİLİ PEMFİGUS VULGARİS: BİR OLGU NEDENİYLE PEMFİGUS VULGARİS. Aydin Dental Journal. 2023;9(2):93-9.

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