Introduction: Pemphigus vulgaris is a rare cause of oral mucosal ulceration.
Clinical picture: A 47-year-old Chinese man presented with a 3-month history of oral ulceration. There were no lesions on the skin or other mucosal sites. Histology and immunostaining were consistent with pemphigus vulgaris.
Treatment: Systemic and topical corticosteroids were instituted, together with topical antifungals. Conventional periodontal therapy was carried out to improve gingival/oral health.
Outcome: Control of oral ulceration was achieved with re-establishment of normal oral function. No other sites to date have been involved.
Conclusions: Chronic oral ulceration can be the sole manifestation of pemphigus vulgaris, at least initially. Early recognition of this lesion may prevent delayed diagnosis and inappropriate treatment of a potentially chronic dermatological condition.