1/2. esophagitis dissecans superficialis associated with pemphigus vulgaris.The extension of bullous lesions in pemphigus to the esophagus is relatively uncommon, especially in patients who appear to be in clinical remission. Very rarely, pemphigus vulgaris may affect the entire esophagus, resulting in complete sloughing of the mucous membrane. A 20-year-old man with pemphigus vulgaris presented to the emergency room with acute onset of dysphagia, odynophagia, and hemoptysis. There were no cutaneous or oral findings of pemphigus on presentation, since he was being maintained on corticosteroids and azathioprine with excellent results. During initial evaluation in the emergency room, the patient was observed to vomit a cast of the mucosal lining of the esophagus. The morphologic description of such an esophageal cast is termed esophagitis dissecans superficialis. This is the third case of esophagitis dissecans superficialis in pemphigus vulgaris recorded in the medical literature.- - - - - - - - - - ranking = 1keywords = vulgaris (Clic here for more details about this article) |
2/2. esophagitis dissecans superficialis associated with pemphigus vulgaris.A number of dermatologic conditions may have associated esophageal manifestations. Teleologically, this may be because both the skin and the esophagus are lined by stratified squamous epithelium. Bullous dermatoses that may produce blisters, erosions, and/or stricture of the esophagus include cicatricial pemphigoid, Hailey-Hailey disease, Darier's disease, various forms of epidermolysis bullosa, bullous pemphigoid, and pemphigus vulgaris. Very rarely, bullous diseases may affect the esophagus in such a manner that there is a sloughing of the entire mucous membrane. The production of such an esophageal cast has been termed esophagitis dissecans superficialis. This is the second case recorded in the medical literature of pemphigus vulgaris associated with esophagitis dissecans superficialis. Additionally, this is the first case of pemphigus vulgaris in which the esophagus is demonstrated to be positive by direct immunofluorescence.- - - - - - - - - - ranking = 1keywords = vulgaris (Clic here for more details about this article) |