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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 1999 December;134(6):595-8
A case of multi-triggered pemphigus vulgaris
Satriano R. A., Fiorentini F., Tripodi Cutrì F., Muto L.
Department of Dermatology, School of Medicine and Surgery, University of Naples II, Naples
Pemphigus vulgaris is a bullous disease which affects skin and keratinizing, or potentially such, mucosae. Aetiology can be unknown or related to several exogenous factors able to cause (induced pemphigus) or favour (triggered pemphigus) the disease in genetically predisposed subjects. A case of a 24-year-old woman with pemphigus vulgaris induced by administration of progesterone, noramidopirine, acetylsalicilic acid and exposure to UV rays is reported. The patient presented with erythematous, squamous, and crustous patches on the scalp, several flaccid blisters on apparently normal skin, erosive areas and sero-ematic crusts on the face, trunk, and limbs, and erosions in the nasal and oral mucosae. Perilesional Nikolsky’s sign was positive. Cytological examination from blisters of the trunk and from oral erosions showed typical acantholytic cells. Biopsy of a fresh bulla revealed suprabasal acantholytic detachments. Indirect immunofluorescence testing showed intercellular autoantibodies at a 1:160 titre. HLA typing detected DR14 and DQ5 alleles, according for a genetic predisposition to the disease. Steroid therapy was started, according to the conventional treatment protocol, and resulting in remission of the disease in 16 weeks, complete disapparence of intercellular autoantibodies in 24 weeks.