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Case Report
2001:67:5;267-267
PMID: 17664772

Isolated pemphigus vegetans of the tongue

Puneet Bhargava, CM Kuldeep, NK Mathur
 Department of Dermatology, STD and Leprosy S.M.S. Medical College, Jaipur-302 004, India

Correspondence Address:
Puneet Bhargava
C-32, Peeyush Path, BapuNagar, Jaipur-1
India
How to cite this article:
Bhargava P, Kuldeep C M, Mathur N K. Isolated pemphigus vegetans of the tongue. Indian J Dermatol Venereol Leprol 2001;67:267
Copyright: (C)2001 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

Pemphigus vegetans affecting only the tongue is reported in a 35-year-old woman
Keywords: Pemphigus vegetans

Introduction

Pemphigus vegetans is a rare clinical variant of pemphigus groups of disorders accounting for 1 to 2 percent of all cases.[1] It predominantly affects middle aged women and is characterized by hypertrophic granulation tissue and vegetative skin lesions involving the axillae, groins and flexures.[2] This variant often affects oral mucosa. Tongue involvement in form of cerebriform tongue[2] or scrotal tongue[2] has been described.

Case Report

Recently a 35-year-old Indian woman was referred to us with 7 years history of vegetative growth on her tongue. She had not taken any treatment for it. Fifteen years back she had biopsy proven oral and skin lesions of pemphigus vulgaris for which she was treated with systemic corticosteroids for 1 year with complete recovery. She had been asymptomatic in the intervening period.

Examination showed hypertrophic vegetative grey plaque on the dorsum of her tongue [Figure - 1], with a number of erythematous eroded areas in the surrounding. Her skin and rest of the oral cavity were normal.

Biopsy from tongue lesion showed marked hyperkeratosis and acanthosis, intraepidemal bullae with acantholytic cells, neutrophils and eosinophils confirming diagnosis of pemphigus vegetans. Immuno-fluorescence couldn′t be done because of lack of facility. Normal investigations included complete hemogram, serum electrolytes, blood sugar, blood urea, serum creatinine and liver function tests.

The possibility of pyostomatitis vegetans[4],[5] was ruled out in view of the histopathological findings and the absence of inflammatory bowel disease.

Patient was treated with oral prednisolone 30 mg/day with complete disappearance of tongue lesions in 3 months.

Discussion

This case is presented because of its rarity and the fact pemphigus vegetans persisted on tongue for seven years without recurrence of lesions on any part of the body.

References
1.
Swati T, Kitazawa K, Dan no K, et al. Pemphigusvegetans with oesophageal involvement: Successful treatment with minocycline and nicotinamide. Br J Dermatol 1995; 332 : 668 - 670.
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2.
Premlata S, Jayakumar S, Yesudian P, et al. Cerebriform tongue-a clinical sign in pemphigus vegetans. Br J Dermatol 1981; 104 : 587-591.
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3.
Iwata M, Watanabe S, Tamaki K. Pemphigus vegetans presenting as scrotal tongue. J Dermatol 1989; 16: 159-160. 4. Neville BW, Smith SE, Maize JC, et al. Pyostomatitis vegetans. Am J Dermatopathol 1985; 7: 69-77.
[Google Scholar]
4.
Storwick GS, Prihoda MB, Fulton RJ, et al. Pyodermatitis - pyostomatitis vegetans : a specific marker for inflammatory bowel disease. J Am Acad Dermatol 1994 ; 31 : 336-341.
[Google Scholar]

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