Abstract
Pemphigus vulgaris is a disease rarely encountered in otolaryngological practice. This report involves a case of asymptomatic pemphigus vulgaris of the larynx.
The patient was a 58-year-old woman who had an eight year history of dermatological corticosteroid therapy for her skin lesions. A laryngeal examination had not been performed because there had been no symptoms involving her throat. A superficial bleeding ulcer of the epiglottis was found incidentally during an upper-gastrointestinal endoscopic examination for her anemia. The patient was referred to us for further laryngeal examinations. She had no active skin lesions at the time of the first visit. Biopsy specimens taken from the epiglottis revealed acantholysis, which appeared on the intraepidermal vesicles. Histological diagnosis showed a laryngeal condition resulting from pemphigus vulgaris. Results of the pemphigus anti-body were negative but the results of the squamous cell carcinoma-related antigen (SCC-RAG) were increased. The ulcer improved with a double dose of the steroid. The epiglottis remained red and swollen.
A review of available literture reveals that laryngeal involvement is not such a rare manifestation of pemphigus vulgaris as might be supposed. We stress that the laryngeal examination is necessary in cases with pemphigus vulgaris, and the SCC-RAG is one of the tools for following up the clinical course.
