PMC4451675_01
Ruptured vesicle in healing phase with scar formation in the neck
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F1
The eyes were noticeably reddish in color and there was visible scarring in bulbar conjunctiva of the right eye [Figures 1 and 2].
Scaring of bulbar conjunctiva on the right eye
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F2
The eyes were noticeably reddish in color and there was visible scarring in bulbar conjunctiva of the right eye [Figures 1 and 2].
Multiple intact bullae on hard palate with erythematous irregular ulcers
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F3
Multiple, intact, translucent vesicles of size ranging from 3 and 5 mm in diameter were present in the anterior hard palate region [Figure 3]. On the right buccal mucosa, an irregular ulceration with erythematous halo, covered by a greyish white slough was seen in relation to 16 and 17 [Figures 3 and 4].
(a) Generalized desquamative gingivitis involving maxilla. (b) Generalized desquamative gingivitis involving mandible
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F4
On the right buccal mucosa, an irregular ulceration with erythematous halo, covered by a greyish white slough was seen in relation to 16 and 17 [Figures 3 and 4].
Parakeratinized stratified squamous epithelium with subepithelial split and inflammatory infiltrate in connective tissue (H&E stain, x100)
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F5
The underlying connective tissue was collagenous with dense and diffuse infiltration of lymphocytes and neutrophils [Figure 5].
(a) Direct immunofluorescence showing linear deposition of immunoglobulin A (IgA) at the basement membrane (Direct immunofluorescence, x 100). (b) Direct immunofluorescence showing linear deposition of immunoglobulin A (IgA) at the basement membrane (Direct immunofluorescence, x 100)
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F6
IgM, IgG, C3 and fibrinogen were negative in DIF [Figure 6]. IIF tested negative for circulating antibodies.
Healing of oral lesion after medication
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F7
The drugs were gradually tapered over time and discontinued as lesions healed [Figure 7].