Pemphigus vulgaris localized to the nose

Pemphigus often begins with localized oral lesions. Initial localized pemphigus lesions elsewhere are less common. A 65-year-old man who presented with one crusted erosion on his nose was diagnosed as having pemphigus and was treated with local and intralesional steroids. Seven months after the onset of the first lesion, others occurred elsewhere on his skin.