This report describes the management of an unusual case of oral pemphigus vulgaris (PV). The patient was referred for a painful single bullous lesion together with a small proliferative area localized in the soft palate. Histology and direct immunofluorescence data were consistent for PV but disclosed unusual signs of high-grade dysplasia in the proliferative area. At surgical removal of the dysplastic area 1 week after the start of cortisone therapy there was no evidence of dysplasia. Histological signs of high-grade dysplasia in oral mucosa are often associated with concurrent or subsequent carcinoma. However, severe inflammation may induce reactive epithelial cell changes and hence mimic histologic dysplasia. Pathologic evaluation of dysplasia in an inflammatory disease like PV may be a diagnostic challenge and a careful pathological evaluation is advisable before choosing between surgical and medical approach.

Gissi, D.B., Tarsitano, A., Baldovini, C., Gabusi, A. (2016). Unusual Histological Evidence of Dysplasia in a Case of Oral Pemphigus Vulgaris. INTERNATIONAL JOURNAL OF SURGICAL PATHOLOGY, 24(8), 733-737 [10.1177/1066896916653674].

Unusual Histological Evidence of Dysplasia in a Case of Oral Pemphigus Vulgaris

GISSI, DAVIDE BARTOLOMEO;TARSITANO, ACHILLE;BALDOVINI, CHIARA;GABUSI, ANDREA
2016

Abstract

This report describes the management of an unusual case of oral pemphigus vulgaris (PV). The patient was referred for a painful single bullous lesion together with a small proliferative area localized in the soft palate. Histology and direct immunofluorescence data were consistent for PV but disclosed unusual signs of high-grade dysplasia in the proliferative area. At surgical removal of the dysplastic area 1 week after the start of cortisone therapy there was no evidence of dysplasia. Histological signs of high-grade dysplasia in oral mucosa are often associated with concurrent or subsequent carcinoma. However, severe inflammation may induce reactive epithelial cell changes and hence mimic histologic dysplasia. Pathologic evaluation of dysplasia in an inflammatory disease like PV may be a diagnostic challenge and a careful pathological evaluation is advisable before choosing between surgical and medical approach.
2016
Gissi, D.B., Tarsitano, A., Baldovini, C., Gabusi, A. (2016). Unusual Histological Evidence of Dysplasia in a Case of Oral Pemphigus Vulgaris. INTERNATIONAL JOURNAL OF SURGICAL PATHOLOGY, 24(8), 733-737 [10.1177/1066896916653674].
Gissi, DAVIDE BARTOLOMEO; Tarsitano, Achille; Baldovini, Chiara; Gabusi, Andrea
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/586386
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