Abstract
A case of pemphigus vulgaris with oral and esophageal involvement in a 41-yearold man is reported. Although there were no skin lesions, the patient had intractable ulcers in the oral cavity. Pemphigus vulgaris was suspected on histopathological examination of a biopsy specimen taken from a bulla of the left side of the maxillary gingiva. Direct immunofluorescence studies showed deposits of IgG and C 3 in the intercellular spaces of the epithelium. Upper gastrointestinal endoscopy, performed because the patient had mild odynophagia, revealed an esophageal ulcer. The histopathological diagnosis was pemphigus vulgaris. Intercellular deposits of IgG and C 3 in the esophageal mucosa were detected by direct immunofluorescence studies. The results of indirect immunofluorescence studies were negative. Of 15 cases of pemphigus vulgaris with esophageal involvement reported in Japan, 4 were in men and 11 were in women; the average age of the patients was 48 years. When esophageal lesions were diagnosed, oral lesions were present in all patients, although skin lesions were found in only 3 patients.
