Localized pemphigus with vegetative features

We present a 58-year-old Jamaican man with an eight-month history of an isolated, vegetative, eroded, and crusted plaque on the posterior aspect of the scalp. One month prior to referral to the Charles C. Harris Skin and Cancer Pavilion he developed a few, scattered erosions on the extremities. A biopsy specimen showed suprabasal acantholysis along with deposition of C3 and IgG on a direct immunofluorescence test. Localized pemphigus is a rare variant of pemphigus vulgaris. Localized pemphigus presents with a localized plaque that remains localized for an extended period of time without generalized bullae formation. Our patient represents an unusual case of localized pemphigus of the scalp with vegetative features.