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The current treatment of pemphigus vulgaris requires the use of corticosteroids, beginning promptly at high dosage with gradual reduction. Occasionally it is necessary to begin therapy as quickly as possible, especially if the patient is very ill, if there is dehydration, or if food intake is interfered with by oral lesions.
The diagnosis of pemphigus is based on the skin biopsy, and ordinary histologic techniques require at least 24 hours. The Tzanck test is not a sufficiently reliable confirmation of the clinical diagnosis upon which to go ahead with high steroid therapy.
Recently we have had 2 patients critically ill with pemphigus in whom it was important to initiate treatment as quickly as possible. Immediate histologic diagnosis was obtained by use of the frozen section technique on a tissue specimen obtained with a 4 mm. punch and stained with hematoxylin
The frozen section technique takes 15-20 minutes. The quality
KOMISARUK E, KOSEK JC. The Frozen Section Diagnosis of Pemphigus. Arch Dermatol. 1962;86(5):669–670. doi:10.1001/archderm.1962.01590110105015
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