A case of herpetiform pemphigus

Abstract

A case of herpetiform pemphigus is reported. A 76-year-old man suffered from erythema, blisters and pruritus on the trunk and extremities for 10 months. Dermatological examination revealed a large number of erythemas, papules, hyperpigmented spots and isolated pinpoint-to-green bean-sized blisters over the erythemas on the trunk and limbs. The blisters appeared hemispheric, with thick walls and clear fluid. Nikolsky's sign was negative. Some blisters were ruptured, with erosive surface. Skin histopathology showed epidermal blisters containing eosinophils and neutrophils, and perivascular infiltrates of lymphohistiocytes and eosinophils in the superficial dermis. Direct immunofluorescence showed reticular deposition of IgG and C3 in the epidermis. Diagnosis was herpetiform pemphigus. The patient was treated with methylprednisolone, cyclophosphamide, rupatadine, ketotifen, and topical compound clobetasol propionate ointment. Nine days later, most of the blisters dried up, and the patient was discharged, without recurrence during 6-month telephone follow-up.

Keywords

• herpetiform pemphigus
• glucocorticoids