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eISSN: 2084-9893
ISSN: 0033-2526
Dermatology Review/Przegląd Dermatologiczny
Bieżący numer Archiwum Artykuły zaakceptowane O czasopiśmie Zeszyty specjalne Rada naukowa Bazy indeksacyjne Prenumerata Kontakt Zasady publikacji prac Standardy etyczne i procedury
Panel Redakcyjny
Zgłaszanie i recenzowanie prac online
SCImago Journal & Country Rank
5/2023
vol. 110
 
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Opis przypadku

The cutaneous form of pemphigus vulgaris of the pemphigus chancre type: clinical and therapeutic implications

Natalia Welc
1
,
Monika Bowszyc-Dmochowska
2
,
Magdalena Jałowska
1
,
Marian Dmochowski
1

  1. Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
  2. Cutaneous Histopathology and Immunopathology Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
Dermatol Rev/Przegl Dermatol 2023, 110, 633-636
Data publikacji online: 2024/02/02
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Introduction:
Pemphigus vulgaris can show non-textbook clinical peculiarities, “pearls”.

Case report:
A middle-aged male presented with a single desquamating crust with impetiginisation in the parietal area of the scalp present for over 2 years. Clinicians initially suspected microbial causes of the disease, including folliculitis decalvans. The patient was prescribed oral itraconazole, and rifampicin with clindamycin without improvement. Since the H + E examination revealed unequivocal features of pemphigus vulgaris, the patient was referred for proper immunopathological diagnostics. Based on the clinical picture, H + E evaluation, direct immunofluorescence, which showed pemphigus IgG4 deposits, and multiparametric ELISA (increased level of anti-desmoglein 3 IgG antibodies), a cutaneous form of pemphigus vulgaris of the pemphigus chancre type was diagnosed. The patient received intralesional injections of betamethasone dipropionate/betamethasone phosphate and rituximab intravenously (total dose of 2 g) with significant improvement.

Conclusions:
This patient illustrates that appropriate treatment, in non-emergency cases, should be implemented only after diagnosing patients at the clinical-laboratory level.



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