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Case report of the successful treatment of pemphigus vulgaris using ovine forestomach matrix graft.

J Surg Case Rep

January 2025

Department of Medical Affairs, Aroa Biosurgery Limited, 64 Richard Pearse Drive, Auckland 2022, New Zealand.

Pemphigus vulgaris (PV) is a subtype of pemphigus and life-altering disorder that results in the formation of intraepithelial blisters in mucosa and skin. Though the etiology is not well understood, it is an autoimmune disorder resulting in acantholytic blisters due to auto-antibodies targeting proteins of keratinocyte adhesion. Rapid diagnosis and restoration of the epidermal layer is imperative for patients with PV as widespread epidermal damage can lead to high morbidity and mortality rates.

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Acute generalized exanthematous pustulosis is a severe cutaneous adverse reaction characterized by the rapid onset of nonfollicular, sterile pustules on an erythematous base, typically accompanied by fever (≥38 °C), neutrophilia (7.0 × 10⁹/L), and characteristic histopathological features. This case report presents the first documented instance of acute generalized exanthematous pustulosis after hyaluronic acid viscosupplementation.

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Importance: Identifying environmental factors that contribute to disease onset/activity in PV stands to improve clinical outcomes and patient quality of life by strategies aimed at reducing specific disease promoting exposures and promoting personalized clinical management strategies.

Objective: To evaluate the association between hydroxychloroquine use and the development of pemphigus using population level, publicly available, FDA-generated data.

Design: Observational, retrospective, case-control, pharmacovigilance analysis.

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