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SN | Author/year | Age (years)/sex | Morphology of pemphigus vulgaris | Morphology of KVE | Investigations | Treatment of KVE | Treatment of pemphigus vulgaris | Outcome of KVE |
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1 | Lehman and el-Azhary [3] | 44.1/male | Focal lesions with oral involvement | Not mentioned | Polymerase chain reaction (PCR), skin swabs, viral culture, direct immunofluorescence | Ganciclovir (PO) (dose and duration not mentioned) | Mycophenolate mofetil, prednisone (modification not mentioned) | Resolved (time to resolution not mentioned) |
51.6/female | Widespread lesions with oral involvement | Not mentioned | PCR, skin swabs, viral culture, direct immunofluorescence | Acyclovir (IV) (dose and duration not mentioned) | Intramuscular corticosteroids (modification not mentioned) | Resolved (time to resolution not mentioned) |
70.2/female | Focal lesions with oral, conjunctival, perianal involvement | Not mentioned | PCR, skin swabs, viral culture, direct immunofluorescence | Valacyclovir hydrochloride 1 gm PO BD × 10 days | Azathioprine, prednisone (modification not mentioned) | Resolved (time to resolution not mentioned) |
39.3/female | Focal lesions with oral involvement | Not mentioned | PCR, skin swabs, viral culture, direct immunofluorescence | Acyclovir (IV) (dose and duration not mentioned) | Mycophenolate mofetil, azathioprine, prednisone (modification not mentioned) | Resolved (time to resolution not mentioned) |
45.9/female | Oral erosions only | Not mentioned | PCR, skin swabs, viral culture, direct immunofluorescence | Valacyclovir hydrochloride 1 gm PO BD × 10 days | None | Resolved (time to resolution not mentioned) |
85.7/female | Focal lesions with oral involvement | Not mentioned | | Acyclovir (IV) (dose and duration not mentioned) | Rituximab (modification not mentioned) | Resolved (time to resolution not mentioned) |
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2 | Nath et al. [8] | 40/female | Not mentioned | Lesions in the face, neck, trunk, upper limbs, and thighs | Tzanck smear positive | Acyclovir 400 mg PO TDS × 5 days | DCP (phase 1, 1st cycle) (modification not mentioned) | KVE not healed and PV worsened, the patient left the hospital in critical condition |
27/female | Not mentioned | Lesions in breasts | Tzanck smear positive | Acyclovir 400 mg PO TDS × 10 days | Dexamethasone cyclophosphamide pulse (DCP) (phase 1, 3rd cycle), prednisolone, cyclophosphamide (modification not mentioned) | KVE resolved, PV unaltered (time to resolution not mentioned) |
26/female | Not mentioned | Lesions in the trunk, upper limbs, and thighs | Tzanck smear positive | Acyclovir 500 mg IV TDS × 18 days | Dexamethasone azathioprine pulse (DAP) (phase 1, 1st cycle), prednisolone, azathioprine (modification not mentioned) | KVE partially healed, the patient left the hospital |
40/female | Not mentioned | Lesions in the trunk | Tzanck smear positive | Acyclovir 400 mg PO TDS × 13 days | DCP (phase 1, 3rd cycle), prednisolone, cyclophosphamide (modification not mentioned) | KVE resolved, PV unaltered (time to resolution not mentioned) |
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3 | Rao et al. [9] | 30/male | Not mentioned | Umbilicated grouped vesicular eruption around the eyes, mouth, and axilla | Tzanck smear positive, IgM positive | Acyclovir 800 mg PO 5 times a day × 14 days | DCP (modification not mentioned) | Resolved (time to resolution not mentioned) |
45/female | Not mentioned | Umbilicated grouped vesicular eruption around the eyes, mouth, and axilla | Tzanck smear positive, IgM positive | Acyclovir 800 mg PO 5 times a day × 14 days | DCP (modification not mentioned) | Succumbed to multiorgan failure |
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4 | Vora et al. [7] | 26/male | Old crusted lesions of PV over the scalp with patchy hair loss | Umbilicated vesicular lesions over the face, chest, back, and limbs | Tzanck smear positive, histopathology suggestive of KVE | Acyclovir 10 mg/kg IV every 8 hours × 10 days | Prednisolone 10 mg, azathioprine 50 mg BD (no modification) | Healed with varicelliform scars (time to resolution not mentioned) |
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5 | Marfatia et al. [10] | 30/male | Erosions in the oral cavity, genitals, and trunk | Not mentioned | HIV positive, chest X-ray suggestive of pulmonary TB | Acyclovir (PO) (dose and duration not mentioned) | Dexamethasone IM TDS, treatment of tuberculosis and HIV (modification not mentioned) | KVE resolved (time to resolution not mentioned) |
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6 | Corral et al. [1] | 33/male | Not mentioned | Painful bullous lesions on the scalp, oral cavity, and trunk | Not mentioned | Acyclovir (IV) (dose and duration not mentioned) | Intravenous immunoglobulin, followed by a second pulse therapy with methylprednisolone, mycophenolate mofetil was held | KVE resolved (time to resolution not mentioned) |
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7 | Feldmeyer et al. [11] | 71/male | Not mentioned | Refractory vegetating skin lesions, especially of the centrofacial area | Nasal smear was positive for HSV2 by direct immunostaining, culture negative | Valacyclovir 500 mg PO BD × 10 days | Prednisone, and cyclosporine, intravenous immunoglobulin (modification not mentioned) | KVE resolved in 10 days and PV also remitted |
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8 | Chiu et al. [12] | 66/female | Not mentioned | Generalized painful lesions over the lower trunk, buttocks, bilateral popliteal, and inguinal areas | Histopathology and immunohistochemistry for herpes virus were positive; HSV IgG increased | Famciclovir 750 mg PO OD × 10 days | Discontinued the systemic steroid | KVE showed remarkable improvement in 10 days |
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9 | Mackley et al. [13] | 72/female | Not mentioned | Innumerable deep, punched-out erosions scattered over the existing geographic erosions | Tzanck smear positive, direct fluorescent antibody test positive for HSV-1 | Acyclovir 15 mg/kg IV OD (duration not mentioned); discharged on chronic prophylactic acyclovir | Prednisone, mycophenolate mofetil, and cyclosporine (modification not mentioned) | Significant improvement (time to resolution not mentioned) |
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10 | Ortiz [14] | 66/male | Not mentioned | Lesions in the chin, cheeks, and neck | Tzanck negative, biopsy suggestive of KVE | Not mentioned | Prednisone, gold salts (modification not mentioned) | Not mentioned |
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11 | Our case (2020) | 67/male | Erosions in the face, neck, chest, and oral cavity | Haemorrhagic crusts in the face, neck, and chest over pre-existing erosions | HSV-1 IGM and IgG positive | Acyclovir 400 mg PO TDS × 4 weeks | Dexamethasone decreased from 16 mg to 9 mg, azathioprine continued | Almost 100% resolution in both KVE and PV within 4 weeks |
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