PMC3124259_01
The initial examination revealed a patchy erythematous labial gingiva around teeth no. 7 and 8.
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Oral examination revealed localized erosions on the marginal gingiva of teeth no. 7 and 8 (Figure 1).
Gentle palpation with a periodontal probe elicited some desquamation of the gingiva around tooth no. 27.
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Nikolsky's sign showed a positive reaction, and the epithelium could be peeled away easily by slightly scratching the surface of the gingiva (Figure 2).
Cytological smear of affected gingiva illustrating a collection of acantholytic Tzank cells.
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In the cytological smear, collective acantholytic cells were recognized (Figure 3).
Histopathologic examination of specimens from the gingiva. Suprabasial acantholysis near the tips of two adjacent rete pegs is recognized.
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On histopathological examination, acantholysis was recognized immediately above the basal cell layer (Figure 4).
Direct immunofluorescence for deposits of IgG. Deposition of IgG was found between the epithelial cells.
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DIF was performed using conjugates for IgG, IgA, IgM, C3, and fibrinogen, and it revealed deposition of IgG and C3 between the epithelial cells (Figure 5).