Severe herpetic gingivostomatitis associated with pemphigus vulgaris

The histologic, immunologic, and virologic data gathered for our patient provide presumptive evidence of the simultaneous presence of primary herpetic gingivostomatitis and pemphigus vulgaris. We do not know which disease appeared first or the relationship, if any, between the two diseases. We would like, however, to emphasize that the almost simultaneous outbreak of the two diseases in the oral mucosa may produce diagnostic and therapeutic difficulties. We support the importance of virologic examinations of bullous oral lesions to rule out the possibility of an HSV infection because of the danger of systemic dissemination of HSV infection in a patient receiving systemic steroid therapy.