Kumar et al identified factors associated with oral lesions of pemphigus vulgaris that are treatment refractory. These lesions may require prolonged and aggressive management. The authors are from Postgraduate Institute of Medical Education and Research in Chandigarh, India.
Patient selection: oral lesions in pemphigus vulgaris
Factors associated with lesions that are refractory to treatment:
(1) longer duration of pemphigus vulgaris (> 9 months)
(2) longer duration of oral lesions (> 8 months)
(3) location of lesions in the retromolar trigone or along the occlusion line of the buccal mucosa
(4) deep, crateriform ulcers OR erosions with lichenoid hues
(5) presence of HSV DNA on PCR
The presence of one or more of these factors may be associated with ulcers that are refractory to therapy.
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