A Cause of Atypical Papanicolaou Smears Pemphigus vulgaris commonly affects mucosal surfaces.
Oral involvement is seen in approximately one half of patients.
Other less commonly involved sites include the esophagus, conjunctiva, nasal mucosa, vagina, and anus. Cervical involvement is quite rare, with less than 20 cases reported in the literature. We report 2 additional cases of cervical pemphigus and describe the abnormalities that may be seen on cytologic smear. These cases illustrate how acantholytic cells on Papanicolaou smears may be misinterpreted as evidence of cervical dysplasia. Tzanck preparation of an intact blister revealed numerous eosinophils and no evidence of multinucleated giant cells.