Turkderm-Turk Arch Dermatol Venereol. 2007; 41(4): 136-138

Pemphigus Vulgaris Localized to the Nose Operated with the Diagnosis of Actinic Keratosis

Mustafa Kulaç¹, Þemsettin Karaca¹, Yavuz Demir², Çiðdem Tokyol^3
1Afyon Kocatepe University, Faculty Of Medicine, Department Of Dermatology
²Afyon Kocatepe University, Faculty Of Medicine, Department Of Plastic And Reconstructive Surgery, Afyon
³Afyon Kocatepe University, Faculty Of Medicine, Department Of Pathology, Afyon

Pemphigus vulgaris is an autoimmune blistering disease characterized by disseminated bullae and erosions of the mucosal surfaces and skin. Although some cases of localized pemphigus without mucosal involvement have been reported, only a few cases limited to nose were presented. Most of these cases have included the patients with pemphigus foliaceus. In the English literature, only 4 pemphigus vulgaris cases persisting lesions localized to the nose have been described previously. Seborrheic dermatitis, impetigo, discoid lupus erythematosus, Darier’s disease, and actinic keratosis were considered for differential diagnosis in all these cases but pemphigus vulgaris was not considered in the initial clinical diagnosis. To date, only one pemphigus vulgaris case mistakenly treated as actinic keratosis was reported. In this case, initial lesion had first occurred in the scalp and oral mucosal lesions had appeared fifteen months later. Here, we present a pemphigus vulgaris case localized to the nose operated with a previous pathological diagnosis of actinic keratosis that did not show mucosal involvement or dissemination during a follow- up period of 2 years. As it is very rare in the clinical practice, collaboration between clinical branches is very important for correct clinical diagnosis and choosing appropriate treatment modality in these cases.

Keywords: Pemphigus vulgaris, localized, nose, actinic keratosis

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Aktinik Keratoz Tanýsýyla Opere Edilen Buruna Lokalize Pemfigus Vulgaris

Mustafa Kulaç¹, Þemsettin Karaca¹, Yavuz Demir², Çiðdem Tokyol^3
1Afyon Kocatepe Üviveristesi Týp Fakültesi, Deri ve Zührevi Hastalýklar Ana Bilim Dalý, Afyon
²Afyon Kocatepe Üviveristesi Týp Fakültesi, Plastik Ve Rekonstrüktif Cerrahi Ana Bilim Dalý, Afyon
³Afyon Kocatepe Üviveristesi Týp Fakültesi, Patoloji Ana Bilim Dalý, Afyon

Pemfigus vulgaris deri ve mukozal yüzeylerde yaygýn bül ve erode lezyonlarla seyreden otoimmün büllöz bir hastalýktýr. Günümüze kadar mukoza tutulumu olmadan belirli bir deri alanýna sýnýrlý pemfigus vakalarý rapor edilmekle beraber, burun derisine sýnýrlý çok az sayýda pemfigus vakasý bildirilmiþtir. Bunlarýn büyük çoðunluðu da pemfigus foliaceus vakalarýndan oluþmaktadýr. Ýngilizce literatürde, lokalize olarak burunda baþlayan ve uzun süreli takiplerinde baþka bölgede lezyon çýkýþý olmayan yalnýzca dört pemfigus vulgaris vakasý bildirilmiþtir. Bu vakalarýn hiçbiri ilk klinik taný olarak pemfigus vulgaris tanýsý almamýþ olup, ayrýcý tanýda seboreik dermatit, diskoid lupus eritematosus, impetigo, darier hastalýðý düþünülmüþtür. Bugüne kadar literatürde yanlýþlýkla aktinik keratoz olarak tedavi edilen yalnýz bir pemfigus vulgaris vakasý sunulmuþ olup, bu vakada ilk lezyon kafa derisinde baþlamýþ; 15 ay sonra da oral mukoza lezyonlarý çýkmýþtýr. Burada aktinik keratoz tanýsýyla opere edilen ve iki yýl boyunca baþka bölgede lezyonu çýkmayan, buruna lokalize bir pemfigus vulgaris olgusunu, çok nadir görüldüðü ve klinik branþlar arasýnda konsültasyonun önemini vurgulamak amacý ile sunuyoruz.

Anahtar Kelimeler: Pemfigus vulgaris, lokalize, burun, aktinik keratoz

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