Solitary verrucous plaque on a leg

Area of Science:

• Dermatology
• Immunopathology
• Histopathology

Background:

• Pemphigus vegetans (PVeg) is a rare autoimmune blistering disease.
• It typically presents with vegetative plaques in intertriginous areas.
• Atypical presentations can mimic other dermatological conditions.

Purpose of the Study:

• To report a rare case of pemphigus vegetans presenting atypically.
• To emphasize the importance of considering PVeg in differential diagnoses.
• To highlight diagnostic challenges in non-intertriginous lesions.

Main Methods:

• Comprehensive clinical examination.
• Histopathological evaluation of skin biopsy.
• Immunopathological assessment for diagnostic confirmation.

Main Results:

• A solitary verrucous plaque on the leg and oral erosions were observed.
• Differential diagnoses included lichen simplex chronicus, hypertrophic lichen planus, and chromoblastomycosis.
• Diagnosis of pemphigus vegetans was confirmed through integrated evaluations.

Conclusions:

• Pemphigus vegetans should be considered in the differential diagnosis of verrucous plaques, even in unusual locations.
• Atypical presentations necessitate thorough diagnostic workup.
• Early and accurate diagnosis is crucial for appropriate management.