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Case Reports in Medicine
Volume 2011, Article ID 518758, 2 pages
Case Report

Unusual Clinical and Pathological Features in Pemphigus Vulgaris: A Potential Diagnostic Pitfall

1Section of Anatomic Pathology, Department G.F. Ingrassia, University of Catania, 95123 Catania, Italy
2Department of Dermatology, University of Catania, “G. Rodolico” Polyclinic, 95123 Catania, Italy

Received 23 December 2010; Accepted 21 January 2011

Academic Editor: Jeffrey M. Weinberg

Copyright © 2011 Rosario Caltabiano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upper lip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, the finding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis with moderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris led us to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. The previously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatory injury.