The Importance of Oral Biopsy in a Thalassemia Patient Affected with Pemphigus- A Rare Case Report

Abstract

Introduction and purpose: Pemphigus is a severe and potentially fatal autoimmune blistering disease. Given the risks associated with misdiagnosis or delayed diagnosis and the possibility of overlapping clinical features and treatments, suspected pemphigus often requires a thorough clinical evaluation and laboratory testing. Studies have also reported the simultaneous presence of pemphigus with neurological, genetic, and metabolic diseases. Few reports of thalassemia have been complicated with pemphigus vulgaris or vice versa. Here we introduce a patient with β -thalassemia  inrermedia who suddenly got pemphigus vulgaris.

Case report: A 31-year-old woman with a painful mouth ulcer was referred to the Oral Diseases Clinic of Semnan University. Oral ulcers started six months ago, and the blisters spread to the whole body after some time.
Several skin biopsies were performed, but each time non-specific inflammation was observed. Oral biopsy revealed the answer to this mystery, and the diagnosis of pemphigus vulgaris was reported. The patient's treatment was started with topical steroids and oral nystatin, and then she was referred to a dermatologist.

Conclusion: Therefore, it is recommended that doctors and dentists, when faced with patients with chronic and multiple oral lesions, consult and cooperate to make the best diagnosis for the patients and benefit from the advantages of early treatment and prevent the use of wrong drugs.