Pemphigus Foliaceus

Key Points
Rare type of pemphigus, typically affecting the torso first, then spreading to the face and/or scalp
Autoimmune disorder which destroys connectivity of skin cells
Consists of small easily ruptured blisters which leave behind erosions, crusting, and inflammation

Pemphigus foliaceus is a rare type of pemphigus which typically affects the torso first and spreads to the face and/or scalp. The condition consists of the formation of small, easily ruptured blisters. Ruptured blisters leave behind skin erosions which may crust and become red and inflamed. This may be accompanied by burning or pain in the affected area.

Pemphigus foliaceus is an autoimmune disorder in which the immune system destroys the connective tissue that holds skin cells together, causing blistering. The condition may be provoked by exposure to sunlight. Additionally, the condition may result from certain medications, and an endemic form of the condition which is provoked by a viral infection is common in South America. The condition may affect any age, gender or ethnic group, but typically appears between 50-60 years of age.

Differential Diagnosis (Other conditions with similar appearance)
Dermatitis
Lupus erythematosus
Drug-Induced Bullous Disorders
Drug-induced Photosensitivity
Papular Urticaria
Epidermolysis bullosa
Pemphigus (various forms)
Epidermolysis bullosa Acquisita
Erysipelas
Erythema multiforme
Erythroderma
Fogo Selvagem
Glucagonoma Syndrome
Pseudoporphyria
Herpes simplex
Subcorneal pustular dermatosis
Impetigo
Insect Bites
Linear IgA dermatosis

Diagnosis
Key Points
Diagnosis based on skin biopsy of the affected area
Staining will be performed to confirm the condition

Pemphigus foliaceus is typically diagnosed based on a skin biopsy of the affected area, and confirmed by a stain of the affected tissue. These tests will also rule out similar appearing conditions.

Treatment
Condition may resolve spontaneously in some cases, and persist in others
Goal of treatment is to prevent further involvement and resolve established lesions
Treatment typically consists of topical corticosteroids and antibiotic medications

Pemphigus foliaceus may resolve spontaneously in some cases, but is often persistent. The goal of treatment is to prevent further involvement and to resolve established lesions. Treatment of the condition typically consists of the application of topical corticosteroids in conjunction with antibiotic medications. In severe cases, more aggressive treatments may be required.