Authors: A Vasiliou T P Nikolopoulos L Manolopoulos J Yiotakis
Publish Date: 2006/11/17
Volume: 264, Issue: 5, Pages: 509-512
Abstract
Pemphigus is an uncommon chronic disease with dermatologic and mucosal manifestations Primary laryngeal involvement without skin lesions is extremely rare The present paper describes a 72year old man who presented with a 2month history of hoarseness haemoptisis and dysphagia Clinical examination revealed an erythematous oral mucosa without ulcerations Indirect laryngoscopy revealed supraglottic ulcerations mainly in the laryngeal surface of the epiglottis and in the right arytenoid The lesions had characteristic gray color membranes The patient underwent microlaryngoscopy under general anesthesia and biopsies were taken for histology that revealed inflammatory and granular lesions with necrosis The diagnosis of pemphigus was based on immunohistopathology and the clinical examination The patient underwent intravenous treatment with high doses of corticosteroids prezolon 75 mg/24 h for 10 days and gradually the dose was reduced to 10 mg/24 h The patient had a very good response to the treatment and after a week approximately 80 of the lesions disappeared However the dose of 10 mg prednisolone per day was sustained for 3 months because any attempt of prednisolone discontinuation was related with reappearance of the clinical symptoms After 3 months finally the treatment was discontinued without problems Now 15 months later the patient is well and without symptoms He is under longterm followup ENT surgeons should be aware of pemphigus as primary laryngeal manifestation in order to investigate and manage patients accordingly
Keywords: