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Updated: May 28, 2026

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid

Published on: June 17, 2025

Scalp Involvement In Pemphigus: A Retrospective Cohort Study Of Clinical And Immunopathologic Features.

Andrea Michelerio^1,2, Stefania Barruscotti^1,2, Mara De Amici³

¹Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.

Dermatology Practical & Conceptual

|May 26, 2026

Summary

Scalp involvement is common in pemphigus, affecting over half of patients and correlating with higher anti-desmoglein-1 (anti-Dsg1) antibody titers and disease severity. Identifying distinct scalp phenotypes aids in diagnosis and management.

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Granulocyte-dependent Autoantibody-induced Skin Blistering

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Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid

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Published on: June 17, 2025

Granulocyte-dependent Autoantibody-induced Skin Blistering

Granulocyte-dependent Autoantibody-induced Skin Blistering

Published on: October 12, 2012

Area of Science:

Dermatology
Autoimmune Diseases
Immunopathology

Background:

Pemphigus is a rare autoimmune blistering disease caused by autoantibodies against desmogleins, leading to skin and mucosal lesions.
Scalp involvement is a frequent but understudied manifestation of pemphigus.

Purpose of the Study:

To investigate the prevalence, clinical presentations, and immunopathological features of scalp involvement in pemphigus.
To explore correlations between scalp lesions, disease severity, and serological markers.

Main Methods:

A retrospective cohort study of 115 pemphigus patients diagnosed between 2012 and 2024.
Assessment of scalp involvement via clinical examination and pull test, alongside collection of demographic, clinical, and serological data.

Main Results:

Scalp involvement was observed in 57.4% of patients, significantly associated with male sex and higher anti-Dsg1 titers.
Patients with scalp involvement exhibited higher Pemphigus Disease Area and Activity Index (PDAI) scores and differed in disease severity stratification.
Three distinct scalp phenotypes were identified: scaling without alopecia, crusting/erosions, and alopecia, each with unique characteristics.

Conclusions:

Scalp involvement is a common feature of pemphigus, linked to increased anti-Dsg1 antibody levels and heightened disease severity.
Recognition of specific scalp phenotypes can facilitate earlier diagnosis and guide more personalized treatment strategies for pemphigus.