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• W2953782901 abstract "To the Editor: We have read the Therapeutic Pearl by Mahmoudi et al on the use of topical trichloroacetic acid (TCA) for treatment of pemphigus vulgaris with great interest.1Mahmoudi H. Balighi K. Tavakolpour S. Daneshpazhooh M. Chams-Davatchi C. Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgaris.J Am Acad Dermatol. 2019; 80: e51-e52Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Chronic refractory oral lesions are a challenge in pemphigus vulgaris treatment, and new treatment proposals are relevant to improve disease management. Nevertheless, as published by some of the authors2Mohammadi F. Khalili Z. Marashi S.M. et al.The potential roles of herpesvirus and cytomegalovirus in the exacerbation of pemphigus vulgaris.Dermatol Pract Concept. 2018; 8: 262-271Crossref PubMed Google Scholar and also well demonstrated in the manuscript they used as reference,3Kumar S. De D. Handa S. et al.Identification of factors associated with treatment refractoriness of oral lesions in pemphigus vulgaris.Br J Dermatol. 2017; 177: 1583-1589Crossref PubMed Scopus (18) Google Scholar we have detected herpes simplex virus (HSV) type 1 previously in mucosal lesions of pemphigus vulgaris patients using immunofluorescence and qualitative PCR assays.4Machado A.R.D.S.R. La Serra L. Turatti A. Machado A.M. Roselino A.M. Herpes simplex virus 1 and cytomegalovirus are associated with pemphigus vulgaris but not with pemphigus foliaceus disease.Exp Dermatol. 2017; 26: 966-968Crossref PubMed Scopus (4) Google Scholar In addition, local trauma during mastication is another differential etiologic cause for refractory oral lesions and a consultation of a dental surgeon is of great relevance in these cases. Both the clinical image and the excellent result from the use of TCA in the reported case have led us to inquire the authors about a possible association of chronic pemphigus vulgaris ulcer with HSV infection, which they did not rule out in their study.1Mahmoudi H. Balighi K. Tavakolpour S. Daneshpazhooh M. Chams-Davatchi C. Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgaris.J Am Acad Dermatol. 2019; 80: e51-e52Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar It would be of interest to collect a mucosal lesion sample for Tzanck smear to investigate HSV infection in pemphigus vulgaris patients with chronic refractory oral lesions before using TCA treatment.5Brito M.M. Tarquínio D.C. Arruda D. Costa R.S. Roselino A.M. Tzanck smears: an old but useful diagnostic tool [in Portuguese].An Bras Dermatol. 2009; 84: 431-433Crossref PubMed Scopus (4) Google Scholar Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgarisJournal of the American Academy of DermatologyVol. 80Issue 3PreviewPemphigus vulgaris (PV) is an autoimmune bullous disease that usually affects the oral mucosa. The delayed healing process of oral ulcers, especially on the buccal mucosa, is among the challenges in treating it.1 Despite the efficacy of systemic therapies and intralesional steroids for accelerating the healing process, they may not be effective in all persistent lesions. Full-Text PDF Reply to: “Comment on ‘Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgaris'”Journal of the American Academy of DermatologyVol. 81Issue 5PreviewTo the Editor: We would like to thank Filho et al1 for their interest in our article “Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgaris.”2 They raised the important subject of the role of herpes simplex virus (HSV) in their comment and inquired about a possible role for this viral infection in the etiology of the chronic ulcer observed and treated with trichloroacetic acid (TCA). As they have mentioned, many studies have reported HSV in pemphigus lesions,3 and the role of this virus as a trigger of pemphigus is also well known in clinical practice. Full-Text PDF" @default.
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• W2953782901 title "Comment on: “Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgaris”" @default.
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