A 40-year-old patient contacted the EMC with complaints of rashes and itching.
The itch appeared two years ago, and a wound formed at the combing site. Skin rashes appeared periodically. At the same time, an ulcer appeared in the oral cavity, which passed without treatment. The patient was at a dermatologist in another clinic, a laboratory examination revealed no pathology, so no treatment was prescribed.
An examination in the EMC revealed a single erosion of the skin near the collarbone.
There are dense serous crusts on the back, surrounded by areas of redness, and many elements of microbial inflammation of the skin.
The doctor suspected an autoimmune disease called "pemphigus." Examination of a skin sample from the lesion showed a superficial, relatively mild form of the disease - seborrheic pemphigus.
To confirm the diagnosis, the doctor recommended a blood test for antibodies to specific components characteristic of this disease.
As a result, a more serious form was revealed - "ordinary or vulgar" pemphigus. Unlike seborrheic pemphigus, without aggressive treatment, vulgar pemphigus usually leads to death.
The disease developed unusually: itching is uncharacteristic for vulgar pemphigus, erosions in the oral cavity healed quickly without treatment, and layered crusts are more characteristic of the more superficial form of pemphigus. There were no blisters on the skin, the main sign of pemphigus. If it were not for additional laboratory testing, the diagnosis would be incorrect, and the approach to treatment would be different.
"Autoimmune diseases are very insidious. Their skin manifestations are often disguised as simpler pathologies, in addition, various forms of autoimmune diseases can manifest themselves in the same way. This complicates the diagnosis and increases the number of incorrect diagnoses and, consequently, incorrectly prescribed treatment. The qualification of a specialist in these cases is extremely important," says Yuri Khaliulin.
The patient has been prescribed the correct treatment, and is currently being successfully monitored by an autoimmune bladder dermatosis specialist.
Dense crusts that made it possible to suspect a dangerous disease
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