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Post-Pemphigus Acanthomata Presenting as an Isolated, Hyperkeratotic Plaque.
Rachita Pandya1, Yanjia Zhou2, Mansee Desai2
1California University of Science and Medicine, Colton, CA 92324, USA.
Dermatopathology (Basel, Switzerland)
|February 22, 2023
Summary
Post-pemphigus acanthomas are rare healing lesions in patients with pemphigus vulgaris or foliaceus. This case highlights a painful, hyperkeratotic plaque on the back diagnosed as a post-pemphigus acanthoma.
Area of Science:
- Dermatology
- Pathology
Background:
- Post-pemphigus acanthomas are uncommon sequelae of pemphigus vulgaris and pemphigus foliaceus.
- Previous literature includes a case series and a case report detailing these lesions.
- These lesions can be challenging to diagnose, especially when solitary.
Observation:
- A 52-year-old female with a history of pemphigus vulgaris presented with a painful, hyperkeratotic plaque.
- The patient had been undergoing topical therapy with fluocinonide 0.05% for four months.
- The lesion was located on the right mid-back.
Findings:
- Histopathological examination confirmed the lesion to be a post-pemphigus acanthoma.
- This diagnosis was made in the context of the patient's pemphigus vulgaris history and topical treatment.
Implications:
- Post-pemphigus acanthomas may be considered variants of hypertrophic pemphigus vulgaris.
- Accurate diagnosis is crucial to differentiate from other conditions like seborrheic keratosis or squamous cell carcinoma.
- This case adds to the limited literature on post-pemphigus acanthomas, emphasizing their occurrence during the healing phase of pemphigus.
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