Document Detail


Laryngeal pemphigus without skin manifestations and review of the literature.
MedLine Citation:
PMID:  17111102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pemphigus is an uncommon chronic disease with dermatologic and mucosal manifestations. Primary laryngeal involvement without skin lesions is extremely rare. The present paper describes a 72-year old man who presented with a 2-month history of hoarseness, haemoptisis and dysphagia. Clinical examination revealed an erythematous oral mucosa without ulcerations. Indirect laryngoscopy revealed supraglottic ulcerations mainly in the laryngeal surface of the epiglottis and in the right arytenoid. The lesions had characteristic gray color membranes. The patient underwent microlaryngoscopy under general anesthesia and biopsies were taken for histology that revealed inflammatory and granular lesions with necrosis. The diagnosis of pemphigus was based on immunohistopathology and the clinical examination. The patient underwent intravenous treatment with high doses of corticosteroids (prezolon 75 mg/24 h) for 10 days and gradually the dose was reduced to 10 mg/24 h. The patient had a very good response to the treatment and after a week approximately 80% of the lesions disappeared. However, the dose of 10 mg prednisolone per day was sustained for 3 months because any attempt of prednisolone discontinuation was related with reappearance of the clinical symptoms. After 3 months, finally the treatment was discontinued without problems. Now, 15 months later, the patient is well and without symptoms. He is under long-term follow-up. ENT surgeons should be aware of pemphigus as primary laryngeal manifestation in order to investigate and manage patients accordingly.
Authors:
A Vasiliou; T P Nikolopoulos; L Manolopoulos; J Yiotakis
Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2006-11-17
Journal Detail:
Title:  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery     Volume:  264     ISSN:  0937-4477     ISO Abbreviation:  Eur Arch Otorhinolaryngol     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-03     Completed Date:  2007-08-23     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9002937     Medline TA:  Eur Arch Otorhinolaryngol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  509-12     Citation Subset:  IM    
Affiliation:
Department of Otorhinolaryngology, Athens University, Ippokration Hospital, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Inflammatory Agents / therapeutic use
Drug Administration Schedule
Humans
Laryngeal Diseases / diagnosis*,  drug therapy
Laryngoscopy
Male
Pemphigus / diagnosis*,  drug therapy
Prednisolone / therapeutic use
Skin Physiological Phenomena*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 50-24-8/Prednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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