BACKGROUND:

The skin diseases of the vulva are a frequent reason for consultation with both gynecologists and dermatologists. The clinical symptoms are usually vague as pruritus or stinging and patients usually consult later.

OBJECTIVE:

To document a case of vulgaris vulvar pemphigus, and review the incidence, clinical presentation, diagnostic strategies and treatment.

CLINCAL CASE:

An 86-year-old patient who came to medical service for ulcerated and burning vulvar lesions of two months of progression. A biopsy was obtained for the histological study, which resulted in acantholysis and suprabasal intraepidermal vesicle, without evidence of dyskeratosis or necrosis. We prescribe topical and oral corticosteroids during a month. Posteriorly, a control study was performed of the most recent lesion that evidenced lymphoplasmacytic inflammatory infiltrate with eosinophilic isolates, without epithelial permeation. Direct immunofluorescence test reported intercellular deposits, IgG throughout the thickness of the epidermis, and C3 in the suprabasal stratum, thus confirming the diagnosis of pemphigus vulgaris.

CONCLUSIONS:

For correct diagnosis it is essential the clinic-pathological correlation, because many of these diseases manifest themselves almost identically.