Eosinophilic spongiosis in early pemphigus foliaceus

A case of widespread non-specific, itchy exanthema in a 74-year-old female is presented. An early skin biopsy showed eosinophilic spongiosis. Later a dermatitis herpetiformis-like eruption developed. However, immunofluorescence microscopy showed intercellular IgG deposits characteristic of pemphigus. Recognition of eosinophilis spongiosis may be helpful in differentiating early pemphigus from other bullous diseases.