Pemphigus Foliaceus in a Patient With Pre-existing Atopic Dermatitis: A Case Report

Area of Science:

• Dermatology
• Immunology
• Autoimmune Diseases

Background:

• Pemphigus foliaceus (PF) is a rare autoimmune blistering disease.
• It involves autoantibodies against desmoglein 1, causing superficial skin erosions and crusts.
• Diagnostic challenges arise when PF initially presents as common dermatoses like atopic dermatitis.

Observation:

• A 55-year-old female with severe atopic dermatitis presented with widespread, pruritic lesions unresponsive to corticosteroids.
• Clinical worsening and new vesiculobullous lesions necessitated re-evaluation.
• Histopathology and serologic testing confirmed a diagnosis of Pemphigus foliaceus.

Findings:

• The patient's Pemphigus foliaceus was confirmed through histopathology and serology.
• Disease control was achieved using a combination of systemic corticosteroids and immunosuppressive therapy.
• The patient has remained in remission for two years.

Implications:

• This case highlights the diagnostic complexity of Pemphigus foliaceus, particularly when symptoms overlap with other skin conditions.
• A high index of suspicion, prompt biopsy, and serological confirmation are vital for accurate PF diagnosis.
• Sustained remission is achievable with long-term immunosuppressive therapy and corticosteroids.