Cervico-vaginal involvement and Papanicolaou smear in pemphigus vulgaris: a clinical study of 77 cases

Abstract

<span>Background and aim: Pemphigus vulgaris (PV) is an autoimmune blistering disease which is known to involve the female genital tract but the frequency at which this occurs is unknown. There are relatively few reports in the literature of the cytological appearance of PV on cervicovaginal smears. Our aim was to evaluate involvement of the female genital tract and cervicovaginal Papanicolaou (Pap) smears in PV.</span><br /><span>Materials and methods: The study included 77 patients with PV visited from April 2005 to February 2007. Each patient was subjected to gynecological examination and cervicovaginal Pap smear.</span><br /><span>Results: The mean age of patients was 44.7±13 years. Genital lesions were observed in 39 patients (50.6%). Labia minor was involved in 36 patients (92.3%), while labia major in 11 (28.2%), vagina in 14 (35.8%), and cervix in six (15.3%). Cervicovaginal smears of 20 patients (25.9%) showed PV. Among 72 satisfactory smears, cervical Pap smears were normal in 25 patients (34.7%), inflammatory in 43 patients (59.7%), and dysplastic (low-grade cervical intra-epithelial neoplasia [CIN I]) in four patients (5.5%). In 2 of these patients, Pap smears was normal repeated when patients were in remission.</span><br /><span>Conclusion: Involvement of the female genital tract might not be as infrequent as was previously thought and it is probably the second most common mucosal site of PV after oral mucosa. Genital lesions may be missed and the need for thorough pelvic examination should not be overlooked.</span>