Delayed Diagnosis of Pemphigus Vulgaris Initially Presenting as an Oral Ulcer: A Case Report

Pemphigus vulgaris is a rare autoimmune mucocutaneous blistering disease clinically presenting as vesicles, bullae, and erosion and histologically characterized by suprabasal split and acantholysis. It usually affects mucous membranes and skin. Recurrent oral ulcers can only be the clinical manifestation before progressing into skin lesions. This can lead to the delayed diagnosis of this disease. Here we report a case of pemphigus vulgaris which was diagnosed after years of suffering from an oral ulcer that eventually progressed to widespread skin blistering and ulceration. The patient was treated with oral prednisolone which showed improvement within a week. Physicians should consider the differential diagnosis of pemphigus vulgaris in patients presenting with a recurrent oral ulcer.