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Persistent Oral Ulcers and Sore Throat

Persistent Oral Ulcers and Sore Throat Abstract REPORT OF A CASE A 75-year-old woman presented with a 6-month history of a sore throat and subsequent development of blisters and ulcerations of the oral mucosa. Two months before, she had noted the appearance of blisters and bullae on the upper trunk and left arm. Treatment with topical fluocinonide gel (0.05% ) by her family physician had no effect on these lesions. Erosions of the nasal mucosa then began to develop. She denied fever and chills but did note an 11.25-kg (25-lb) weight loss over this 6-month period. Other particulars of her medical and family history were noncontributory.Physical examination revealed an elderly woman who appeared chronically ill. Multiple crusted lesions on her scalp with associated alopecia were noted (Fig 1). On the medial canthus was one erosive erythematous lesion with crusting, and multiple shallow ulcers were present around both nares. Erosions were also noted throughout the pharynx, hard and References 1. Meurer M, Millns JL, Rogers RS, et al. Oral pemphigus vulgaris: a report of ten cases . Arch Dermatol. 1977;113:1520-1525.Crossref 2. Asboe-Hansen G. Blister spread induced by finger pressure, a diagnostic sign in pemphigus . J Invest Dermatol. 1960;34-5-9. 3. Kaplan RP, Touloukian J, Ahmed AR, et al. Esophagitis dissecans superficialis associated with pemphigus vulgaris . J Am Acad Dermatol. 1981;4:682-687.Crossref 4. Sison-Fonacier L, Bystryn JC. Regional variations in antigenic properties of skin: a possible cause for disease-specific distribution of skin lesions . J Exp Med. 1966;164:2125-2130.Crossref 5. Lynch PJ, Gallego RE, Saied NK, et al. Pemphigus: a review . Arizona Med. 1976;33:1030-1037. 6. Krain LS, Terasaki PI, Newcomer VD, et al. Increased frequency of HLA-A10 in pemphigus vulgaris . Arch Dermatol. 1973;108:803-805.Crossref 7. Katz SI, Dahl MV, Penneys N, et al. HLA antigens in pemphigus . Arch Dermatol. 1973;108:53-55.Crossref 8. Park MS, Terasaki PI, Ahmed AR, et al. HLA-DRw4 in 91% of Jewish pemphigus vulgaris patients . Lancet. 1979;2:441-442.Crossref 9. Beutner EH, Jordon RE. Demonstration of skin antigens in sera of pemphigus vulgaris patients by indirect immunofluorescent staining . Proc Soc Exp Biol Med. 1964;117:505-510.Crossref 10. Peck SM, Osserman KE, Weiner LB, et al. Studies in bullous diseases: immunofluorescent serologic tests . N Engl J Med. 1968;279: 951-958.Crossref 11. Hu CH, Michel B, Schiltz JR. Epidermal acantholysis induced in vitro by pemphigus autoantibody: an ultrastructural study . Am J Pathol. 1978;90:345-361. 12. Schiltz JR, Michel B, Papay R. Pemphigus antibody interaction with human epidermal cells in culture: a proposed mechanism for pemphigus acantholysis . J Clin Invest. 1978;62:778-788.Crossref 13. Eyre RW, Stanley JR. Identification of pemphigus vulgaris antigen extracted from normal human epidermis and comparison with pemphigus foliaceous antigen . J Clin Invest. 1988;81:807-812.Crossref 14. Hashimoto K, Shafran KM, Webber PS, et al. Anti-cell surface pemphigus autoantibody stimulates plasminogen activator and activity of human epidermal cells . J Exp Med. 1983;157:259-272.Crossref 15. Anhalt GJ, Patel HP, Labib RS, et al. Dexamethasone inhibits plasminogen activator activity in experimental pemphigus in vivo but does not block acantholysis . J Immunol. 1986;136:113-117. 16. Korman N. Pemphigus . J Am Acad Dermatol. 1988;18:1219-1238.Crossref 17. Singer KH, Hashimoto K, Jensen PJ, et al. Pathogenesis of autoimmunity in pemphigus . Annu Rev Immunol. 1985;3:87-108.Crossref 18. Bystryn JC. Adjuvant therapy of pemphigus . Arch Dermatol. 1984;120:941-951.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Persistent Oral Ulcers and Sore Throat

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680050133017
Publisher site
See Article on Publisher Site

Abstract

Abstract REPORT OF A CASE A 75-year-old woman presented with a 6-month history of a sore throat and subsequent development of blisters and ulcerations of the oral mucosa. Two months before, she had noted the appearance of blisters and bullae on the upper trunk and left arm. Treatment with topical fluocinonide gel (0.05% ) by her family physician had no effect on these lesions. Erosions of the nasal mucosa then began to develop. She denied fever and chills but did note an 11.25-kg (25-lb) weight loss over this 6-month period. Other particulars of her medical and family history were noncontributory.Physical examination revealed an elderly woman who appeared chronically ill. Multiple crusted lesions on her scalp with associated alopecia were noted (Fig 1). On the medial canthus was one erosive erythematous lesion with crusting, and multiple shallow ulcers were present around both nares. Erosions were also noted throughout the pharynx, hard and References 1. Meurer M, Millns JL, Rogers RS, et al. Oral pemphigus vulgaris: a report of ten cases . Arch Dermatol. 1977;113:1520-1525.Crossref 2. Asboe-Hansen G. Blister spread induced by finger pressure, a diagnostic sign in pemphigus . J Invest Dermatol. 1960;34-5-9. 3. Kaplan RP, Touloukian J, Ahmed AR, et al. Esophagitis dissecans superficialis associated with pemphigus vulgaris . J Am Acad Dermatol. 1981;4:682-687.Crossref 4. Sison-Fonacier L, Bystryn JC. Regional variations in antigenic properties of skin: a possible cause for disease-specific distribution of skin lesions . J Exp Med. 1966;164:2125-2130.Crossref 5. Lynch PJ, Gallego RE, Saied NK, et al. Pemphigus: a review . Arizona Med. 1976;33:1030-1037. 6. Krain LS, Terasaki PI, Newcomer VD, et al. Increased frequency of HLA-A10 in pemphigus vulgaris . Arch Dermatol. 1973;108:803-805.Crossref 7. Katz SI, Dahl MV, Penneys N, et al. HLA antigens in pemphigus . Arch Dermatol. 1973;108:53-55.Crossref 8. Park MS, Terasaki PI, Ahmed AR, et al. HLA-DRw4 in 91% of Jewish pemphigus vulgaris patients . Lancet. 1979;2:441-442.Crossref 9. Beutner EH, Jordon RE. Demonstration of skin antigens in sera of pemphigus vulgaris patients by indirect immunofluorescent staining . Proc Soc Exp Biol Med. 1964;117:505-510.Crossref 10. Peck SM, Osserman KE, Weiner LB, et al. Studies in bullous diseases: immunofluorescent serologic tests . N Engl J Med. 1968;279: 951-958.Crossref 11. Hu CH, Michel B, Schiltz JR. Epidermal acantholysis induced in vitro by pemphigus autoantibody: an ultrastructural study . Am J Pathol. 1978;90:345-361. 12. Schiltz JR, Michel B, Papay R. Pemphigus antibody interaction with human epidermal cells in culture: a proposed mechanism for pemphigus acantholysis . J Clin Invest. 1978;62:778-788.Crossref 13. Eyre RW, Stanley JR. Identification of pemphigus vulgaris antigen extracted from normal human epidermis and comparison with pemphigus foliaceous antigen . J Clin Invest. 1988;81:807-812.Crossref 14. Hashimoto K, Shafran KM, Webber PS, et al. Anti-cell surface pemphigus autoantibody stimulates plasminogen activator and activity of human epidermal cells . J Exp Med. 1983;157:259-272.Crossref 15. Anhalt GJ, Patel HP, Labib RS, et al. Dexamethasone inhibits plasminogen activator activity in experimental pemphigus in vivo but does not block acantholysis . J Immunol. 1986;136:113-117. 16. Korman N. Pemphigus . J Am Acad Dermatol. 1988;18:1219-1238.Crossref 17. Singer KH, Hashimoto K, Jensen PJ, et al. Pathogenesis of autoimmunity in pemphigus . Annu Rev Immunol. 1985;3:87-108.Crossref 18. Bystryn JC. Adjuvant therapy of pemphigus . Arch Dermatol. 1984;120:941-951.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jun 1, 1991

References