CAN PEMPHIGUS-VULGARIS BE INDUCED BY NUTRITIONAL FACTORS

We present an unusual case of oral pemphigus vulgaris (PV) in a 42-yea r-old woman, in whom the lesions regressed spontaneously upon each of four hospitalizations and relapsed at home. Thr inducing factor was fo und to be leek, which was the main constituent of her three meals a cl ay. Tile diagnosis of PV was confirmed by IIF, immunoblot of epidermal extract and baculovirus recombinant PVA protein, A leek-free diet pro duced regression of oral lesions and a fail in pemphigus antibody tite rs to almost undectable levels, whereas the leek challenge induced rel apse and an increase of antibody titers. It is to be presumed that the leek-induced pemphigus in our case is comparable to pemphigus induced by penicillamine and captopril or other thiol drugs in genetically pr edisposed individuals. It is possible that drug-induced pemphigus, whi ch does not regress after withdrawal of the offending compound, might be maintained by the nutritional factors, if their concentration excee ds the individual threshold of tolerance.