A case of oral pemphigus vulgaris
This case report describes the case of a patient who complained of ulcers of the mouth and difficulty in swallowing since 20 days, who was diagnosed as having Pemphigus vulgaris. Due to early diagnosis, lower doses of medication for a shorter period of time could control the disease.

A 40-year-old male patient resident of Karwar, Karnataka, reported with the chief complaint of ulcers in the mouth and difficulty in swallowing solid food and liquids since 20 days. History revealed that the patient first noticed dysphagia for solid food which progressively increased in severity.

At the time of presentation, the patient had dysphagia for liquid as well. The patient had noticed ulcers of the mouth which bled on brushing, and increased salivation in the morning was reported. The patient did not report of skin lesions or involvement of other mucosal sites.

Intra-oral examination revealed ulcerative lesions present on bilateral buccal mucosa along the line of occlusion extending from retrocommisural areas to the retromolar trigone posteriorly. Lesions extended superiorly from the line of occlusion and were irregular in shape covered by pseudomembrane with erythematous surrounding. On manipulation, bleeding was present.

Similar lesions with irregular borders associated with flaacid bullae were present in the lower buccal vestibule in relation to molar region. Lesions were also present posteriorly on the lateral border of the tongue on left side. Erosive lesions were seen involving posterior hard plate, soft palate, faucial pillars and extending to the oropharynx. There were diffuse areas of erosions covered by pseudo membrane at some sites. Nikolysky's sign showed a positive reaction.

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