Pemphigus foliaceus: A rare case of exfoliative dermatitis

Abstract

Exfoliative dermatitis (ED) is a dermatological condition necessitating admission as it can sometimes be fatal because of its metabolic burden and complications. Papulosquamous disorders and drug reactions comprise over 75% of all the causes of ED. One must be vigilant for the rarer causes of ED as treatment protocols vary and prompt institution of treatment is lifesaving. We present a case of a 56-year-old man with ED who had a history of developing recurrent crusted lesions over the scalp and trunk over the last 3 years. He was treated with oral steroids which he stopped abruptly 6 months ago. Then, he applied topical herbal medications over the lesions before the skin disease progressed to the present state of ED. We uncovered his old records where the histopathology and direct immunofluorescence studies aided in the diagnosis. Based on the history, examination findings supported by histopathology and immunofluorescence studies we came to a final diagnosis of ED secondary to pemphigus foliaceus. This case has been reported for the rare presentation of a common immunobullous disorder and to highlight its diagnostic difficulties.

Keywords

• direct immunofluorescence
• exfoliative dermatitis
• immunofluorescence of hair follicle
• pemphigus foliaceus