A Case of Pemphigus Foliaceus Presenting as Verrucous Plaque

Chang, Dae Sung; Kim, Myeung Nam; Hong, Chang Kwun; Ro, Byung In

Abstract

Pemphigus foliaceus is a rare, relatively mild and chronic variety of pemphigus which is characterized by superficial flaccid bullae which show acantholytic changes in the upper part of the epidermis histopathologically. Present case is a 40-year-old female with a 2 month history of yellowish colored verrucous plaques on the whole scalp. 6 years ago, she had been admitted to our hospital because of nearly generalized erythematous eroded patches, crusted plaques and bullae and diagnosed as pemphigus foliaceus and treated with corticosteroid and methotrexate. 2 months ago, an additional lesion was found on the scalp, where yellowish colored, verrucous surfaced plaques were observed. Histologic examination on the verrucous plaque showed hyperkeratosis, acanthosis and papillomatosis with acantholysis in the granular layer, leading to a subcorneal blister and dyskeratotic granular keratinocytes were seen within the blister. On the basis of clinicopathologic examination we diagnosed as pemphigus foliaceus and then we treated her with prednisolone and the skin lesion had subsided 7 months later. We report a patient of pemphigus foliaceus who was presented with verrucous surfaced plaque, which clinically mimicked pemphigus vegetans.