ORAL PEMPHIGUS-VULGARIS ASSOCIATED WITH INFLAMMATORY BOWEL-DISEASE AND HERPETIC GINGIVOSTOMATITIS IN AN 11-YEAR-OLD GIRL

An 11-year-old girl with recently diagnosed oral pemphigus vulgaris de veloped a severe exacerbation of mouth ulceration due to superinfectio n with herpes simplex virus type I. A concurrent diagnosis of chronic inflammatory bowel disease was established to explain symptoms of weig ht loss and intermittent bloody diarrhea that predated the oral ulcera tion by several years. Herpes simplex infection is a recognized compli cation of pemphigus vulgaris that may be mistaken for a recrudescence of the disease. The association of pemphigus with chronic inflammatory bowel disease has been documented in a small number of adults. Its re lationship to pyostomatitis vegetans, an acknowledged marker for ulcer ative colitis and Crohn disease, remains unclear.