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

Natalia Welc; Monika Bowszyc-Dmochowska; Magdalena Jałowska; Marian Dmochowski

doi:10.5114/dr.2023.130320

eISSN: 2084-9893
ISSN: 0033-2526

Dermatology Review/Przegląd Dermatologiczny

Current issue Archive Manuscripts accepted About the journal Special Issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures

Editorial System

Submit your Manuscript

Editorial Policies

Sarajevo Declaration on Integrity and Visibility of Scholarly Publications

Open access

5/2023
vol. 110

Send email

Copy url:

abstract:

Case report

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

Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
Cutaneous Histopathology and Immunopathology Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland

Dermatol Rev/Przegl Dermatol 2023, 110, 633-636

DOI: https://doi.org/10.5114/dr.2023.130320

Online publish date: 2024/02/02

View full text Get citation

PlumX metrics:

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.

keywords:

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

pemphigus vulgaris, scalp, pemphigus chancre

Natalia Welc

¹

,

Monika Bowszyc-Dmochowska

²

,

Magdalena Jałowska

¹

,

Marian Dmochowski

¹