involvement in pemphigus vulgaris of the female genital tract including the
vulva, vagina and cervix has previously been described. In all these cases
Ether cutaneous and mucosal sites have also been affected at some time. We
describe a case of pemphigus vulgaris which only involved the vaginal muco
sa, The patient presented with a persistent vaginal discharge and examinati
on showed extensive vaginal erosions. Histology of vaginal biopsies was non
-diagnostic. The recognition that the vaginal changes map represent an immu
nobullous disease led to further vaginal biopsies on which direct immunoflu
orescence studies were performed, These biopsies showed IgG and C3 in the i
ntercellular epidermis, suggesting a diagnosis of pemphigus vulgaris. Durin
g the 3-year period that the patient has been under review there have never
been any other cutaneous or mucosal lesions. To our knowledge, this is the
first case of pemphigus vulgaris localized exclusively to the vaginal muco
sa, There was considerable delay in diagnosis and this case highlights how
important it is to recognize that chronic mucosal lesions at genital sites
may be caused by immunobullous diseases such as cicatricial pemphigoid and
pemphigus, and to institute appropriate investigations.