Pemphigus Vegetance a Clinical , Histopathological and Theraputic Study in Iraqi Patients

Abstract

Background: Pemphigus vegetans is a very rare form of pemphigus vulgaris , with a similar etiology and early histological changes , it comprise only 1-2% of cases and of two variety (Neumann and Hallopeau) . It begins and ends as pemphigus vulgaris clinically and histologically , but many of the denuded areas heal with verrucous vegetations and epidermal hyperplasia , that may contain small pustules in the early stages .

Objectives: The study was done to identify that pemphigus vegetans may be manifested for the first time on the body of the nose , as a well defined , indurated , slightly elevated verrucous , hypertrophic and erythematous plaque .

Patients and methods : Eight patients were seen in the Department of Dermatology and Venereolgy in Baghdad and Baquba Teaching Hospitals , during the period from Nov. 2001 to Dec. 2004 . All of them were males  with a mean age of 45 years (their ages ranged from 30-81years) . They complained of vegetating plaques on the body of the nose , which were diagnosed clinically and histologically as pemphigus vegetans and treated by topical clobetasol dipropoint 0.05% ointment twice daily and 40mg /day prednisolone as a single oral morning dose .

Results: The study shows that pemphigus vegetans may be manifested for the first time on the body of the nose , as a well defined slightly elevated erythematous , verrucous and hypertrophic plaques , with typical histological changes of pemphigus vegetans and good response to topical clobetasol dipropoint as 0.05% ointment and oral prednisolone 40mg /day as a single dose .