The cause of pemphigus vulgaris is autoimmune.
The serum containes antibodies against the intercellular substance of stratifi :d epithelium, as demonstrated by means of immunofluorescent staining.
Therefore antigen-antibody reaction takes place in the . intercellular spaces of squamous epithelium and leads to acantholysis.
The association of pemphigus with malignant conditions was frequently reported. Thus there is now increasing evidence of an association between malignancy and the production of pemphigus antibodies by a tumor itself.
By the evidence that pemphigus is autoimmune disease, it is used to treat with corticosteroid and immunosuppressive drugs, such as methotregate.
Very high doses of corticosteroid appear to be necessary for an adequate control of the disease. Even though large dose repersents an effective treatment of pemphigus vulgaris, side effects from this form of therapy have been quite significant.
Two cases of pemphigus vulgaris are reported.
First patient, a 33 year-old housewife, with flaccid bullae and rupture to form erosions of 3 months´ duration especially on buccal mucosa and genitlia. ´Second patient, a 66 year-old female, with above skin lesions of 6 months duration on buccal mucosa and whole body.
Clinically and histopathologica.11y their eruptions were consistent with pemphigus vulgaris.
Large initial dose of prednisolone was employed in these treatment.
These patients were improved with treatment prednisolone. Prednisolone therapy gave rise to a large number of side effects of varying degrees of severity, such as iatrogenic diabetes mellitus, oral candidiasis, hypokalemia, and psychosis etc.
At admission 57days, first case complained of lower abdominal pain and tenderness. At this point it was found clinically that the mass on vaginal vault is present. Punch biopsy was performed and confirmed epidermoid carcinoma poorly differentiated (stage V).
Cystoscopy showed tumor mass of cervix with extension to bladder posterior wall. We advised external radiation therapy for carcinoma for about 5 weeks (5, 0 00 Rads) but hopeless she was discharged. Second patient was much improved without recurrence. Side effects of prednisolone were also controlled.
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