Genital involvement in pemphigus vulgaris (PV): Correlation with clinical and cervicovaginal Pap smear findings

Background: The frequency of genital involvement in pemphigus vulgaris (PV) has not been clearly defined. Objectives: We sought to evaluate the frequency of cervical, vaginal, and vulvar involvement in PV and to determine their association with genital symptoms, clinical involvement, and cytological status. Methods: The current study's sample included 34 female patients with PV. Gynecologic and ear, nose, and throat examinations and indirect immunofluorescence analyses were performed, and Pap smears were collected. Results: Genital involvement was observed in 44.1% of patients. It was significantly associated with disease severity and clinical involvement. Pharyngeal involvement was observed in 61.8% of patients and was the second-most frequently involved mucosal region. Genital involvement was significantly associated with nasal mucosa involvement. Cervicovaginal Pap smears showed acantholytic cells of PV in 35.3% of patients. Limitation: The sample size is small. Conclusion: Genital involvement in PV is not rare. Genital mucosa is the most affected mucosal region after oral and pharyngeal mucosa. Furthermore, genital involvement is significantly associated with nasal involvement and genital symptoms. The need for complete gynecologic evaluations of patients with PV, nasal involvement, and genital symptoms is emphasized.