Cervical Pemphigus Vulgaris Presenting as Postmenopausal Bleeding
Bibliographic record
Abstract
Pemphigus vulgaris is a severe mucocutaneous blistering disease with rare genital involvement. When present, female genital involvement is typically vulvo-vaginal and associated with characteristic bullous lesions elsewhere, most commonly in the oral cavity. Postmenopausal bleeding as a symptom of pemphigus is not reported to date. We present 2 cases of pemphigus vulgaris with postmenopausal bleeding that led to significant work-up for the patients, including hysterectomy for 1 patient. The site of bleeding was established to be related to cervical involvement in 1 patient and assumed to be of cervical origin in the other. As improving treatment modalities result in long-term survival in patients with pemphigus, isolated genital relapse/recurrence of pemphigus vulgaris involving the cervix may result with symptoms not previously attributed to the disease including postmenopausal bleeding. Both gynecologists and pathologists need to be aware of this possibility to accurately label symptoms as disease related and avoid unnecessary interventions for patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".