Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-30T23:53:03.830Z Has data issue: false hasContentIssue false
  • English
  • Français

Laryngeal involvement in pemphigus vulgaris: a proposed classification

Published online by Cambridge University Press:  18 July 2012

A Mahmoud ,
I D Miziara ,
K C Costa ,
C G Santi ,
C W Maruta  and
V Aoki
A Mahmoud*
Affiliation:
Department of ENT, São Paulo University School of Medicine, Brazil
I D Miziara
Affiliation:
Department of ENT, São Paulo University School of Medicine, Brazil
K C Costa
Affiliation:
Department of ENT, São Paulo University School of Medicine, Brazil
C G Santi
Affiliation:
Department of Dermatology, São Paulo University School of Medicine, Brazil
C W Maruta
Affiliation:
Department of Dermatology, São Paulo University School of Medicine, Brazil
V Aoki
Affiliation:
Department of Dermatology, São Paulo University School of Medicine, Brazil
*
Address for correspondence: Dr Ali Mahmoud, Avenida Enéas de Carvalho Aguiar 155, 6° Andar, Sala 06, Cerqueira César, São Paulo, SP, CEP 05403–900, Brazil E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

(1) To investigate the incidence of laryngeal involvement in a large series of patients with pemphigus vulgaris, using endoscopic examination, (2) to describe the lesions, and (3) to establish a classification of laryngeal involvement in pemphigus vulgaris based on the location of the lesions.

Study design:

Prospective study.

Methods:

A total of 40 sequentially treated pemphigus vulgaris patients, diagnosed using clinical, histological and immunofluorescence criteria, were evaluated for laryngeal manifestations using endoscopic examination. The results were used to establish a graded classification of laryngeal involvement according to the location of the lesions.

Results:

Active laryngeal lesions (ulcers or blisters) were found in 16 patients (40 per cent). Of these, 37.5 per cent were classified as grade I, 20 per cent as grade II, 20 per cent as grade III and 17.5 per cent as grade IV.

Conclusion:

Laryngeal involvement is common in pemphigus vulgaris and must be considered at the point of diagnosis. Grade I lesions are the most frequent.

Keywords

PemphigusLarynx
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 1041 - 1044
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Espana, A, Fernandez, S, del Olmo, J, Marquina, M, Pretel, M, Ruba, D et al. Ear, nose and throat manifestations in pemphigus vulgaris. Br J Dermatol 2007;156:733–7CrossRefGoogle ScholarPubMed
2Hale, EK, Bystryn, JC. Laryngeal and nasal involvement in pemphigus vulgaris. J Am Acad Dermatol 2001;44:609–11CrossRefGoogle ScholarPubMed
3Samy, LL, Girgis, IH, Wasef, SA. Pharyngeal and laryngeal pemphigus. J Laryngol Otol 1968;82:111–21CrossRefGoogle ScholarPubMed
4Wallner, LJ, Alexander, RW. Pemphigus of the larynx. Laryngoscope 1964;74:575–86CrossRefGoogle ScholarPubMed
5Weinstein, S, Sachs, AR. Pemphigus of the oropharynx and larynx; report of a case. AMA Arch Otolaryngol 1955;62:214–17CrossRefGoogle ScholarPubMed
6Vasilou, A, Nikolopoulos, TP, Manolopoulos, L, Yiotakis, J. Laryngeal pemphigus without skin manifestations and review of the literature. Eur Arch Otorhinolaryngol 2007;264:509–12CrossRefGoogle Scholar
7Danczak-Pazdrowska, A, Pazdrowski, J, Bowszyc-Dmochowska, M, Dmochowski, M. Laryngeal lesions in mucosal dominant subtype of pemphigus vulgaris. Otolaryngol Pol 2007;61:509–12Google ScholarPubMed
8Langan, SM, Smeeth, L, Hubbard, R, Fleming, KM, Smith, CJ, West, J. Bullous pemphigoid and pemphigus vulgaris – incidence and mortality in the UK: population based cohort study. BMJ 2008;337:a180CrossRefGoogle ScholarPubMed
9Miziara, ID, Ximenes Filho, JA, Ribeiro, FC, Brandão, AL. Oral involvement in pemphigus vulgaris [in Portuguese]. Rev Bras Otorrinolaringol 2003;69:327–31CrossRefGoogle Scholar
10Aoki, V, Huang, MH, Périgo, AM, Fukumori, LM, Maruta, CW, Santi, CG et al. Endemic pemphigus foliaceus (fogo selvagem) and pemphigus vulgaris: immunoglobulin G heterogeneity detected by indirect immunofluorescence. Rev Hosp Clin Fac Med Sao Paulo 2004;59:251–6CrossRefGoogle ScholarPubMed
11Harman, KE, Gratian, MJ, Shirlaw, PJ, Bhogal, BS, Challacombe, SJ, Black, MM. The transition of pemphigus vulgaris into pemphigus foliaceus: a reflection of changing desmoglein 1 and 3 autoantibody levels in pemphigus vulgaris. Br J Dermatol 2002;146:684–7CrossRefGoogle ScholarPubMed