Pemphigus Foliaceus Differential Diagnoses

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 15, 2012
 
 
 
Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

Slawomir Majewski, MD  Professor and Director, Department of Dermatology and Venereology, Warsaw School of Medicine, Poland

Disclosure: Nothing to disclose.

Sebastian S Majewski, MD  Consulting Staff, Department of Dermatology, Military Institute of Health Services, Warsaw, Poland

Disclosure: Nothing to disclose.

Specialty Editor Board

Robin Travers, MD  Assistant Professor of Medicine (Dermatology), Dartmouth University School of Medicine; Staff Dermatologist, New England Baptist Hospital; Private Practice, SkinCare Physicians

Robin Travers, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Informatics Association, Massachusetts Medical Society, Medical Dermatology Society, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Julia R Nunley, MD  Professor, Program Director, Dermatology Residency, Department of Dermatology, Virginia Commonwealth University Medical Center

Julia R Nunley, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Nephrology, International Society of Nephrology, Medical Dermatology Society, Medical Society of Virginia, National Kidney Foundation, Phi Beta Kappa, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
  1. Nikolski PV. Materiali K.uchenigu o pemphigus foliaceus [doctoral thesis]. Kiev. 1896.

  2. Chorzelski T, Jablonska S, Blaszczyk M. Immunopathological investigations in the Senear-Usher syndrome (coexistence of pemphigus and lupus erythematosus). Br J Dermatol. Apr 1968;80(4):211-7. [Medline].

  3. Jablonska S, Chorzelski TP, Beutner EH, Chorzelska J. Herpetiform pemphigus, a variable pattern of pemphigus. Int J Dermatol. Jun 1975;14(5):353-9. [Medline].

  4. Abreu-Velez AM, Hashimoto T, Bollag WB, et al. A unique form of endemic pemphigus in northern Colombia. J Am Acad Dermatol. Oct 2003;49(4):599-608. [Medline].

  5. Abreu-Velez AM, Beutner EH, Montoya F, Bollag WB, Hashimoto T. Analyses of autoantigens in a new form of endemic pemphigus foliaceus in Colombia. J Am Acad Dermatol. Oct 2003;49(4):609-14. [Medline].

  6. Chorzelski TP, Hashimoto T, Amagai M, et al. Paraneoplastic pemphigus with cutaneous and serological features of pemphigus foliaceus. Br J Dermatol. Aug 1999;141(2):357-9. [Medline].

  7. Grando SA, Holubar K, Schwartz RA. Jean-Claude Bystryn 1938-2010. An obituary. Exp Dermatol. Mar 2011;20(3):293-6. [Medline].

  8. Ishii K, Amagai M, Komai A, et al. Desmoglein 1 and desmoglein 3 are the target autoantigens in herpetiform pemphigus. Arch Dermatol. Aug 1999;135(8):943-7. [Medline].

  9. Kubo A, Amagai M, Hashimoto T, et al. Herpetiform pemphigus showing reactivity with pemphigus vulgaris antigen (desmoglein 3). Br J Dermatol. Jul 1997;137(1):109-13. [Medline].

  10. Masmoudi A, Baricault S, Chikrouhou H, et al. [Tunisian pemphigus foliaceus with antidesmoglein 3 antibody]. Ann Dermatol Venereol. Jan 2008;135(1):69-70. [Medline].

  11. Wu H, Wang ZH, Yan A, et al. Protection against pemphigus foliaceus by desmoglein 3 in neonates. N Engl J Med. Jul 6 2000;343(1):31-5. [Medline].

  12. Grando SA. Cholinergic control of epidermal cohesion. Exp Dermatol. Apr 2006;15(4):265-82. [Medline].

  13. Ruocco V, Ruocco E. Pemphigus and environmental factors. Giornale Dermatol Venereol. 2003;138:299-309.

  14. Ruocco V. Attualita' sul pemfigo indotto. Capri, Italy: 2003. 41st Italian National Dermatology Congress.

  15. Pigozzi B, Peserico A, Schiesari L, Alaibac M. Pemphigus foliaceus evolving into pemphigus vulgaris: a probable example of 'intermolecular epitope spreading' confirmed by enzyme-linked immunosorbent assay study. J Eur Acad Dermatol Venereol. Feb 2008;22(2):242-4. [Medline].

  16. Dalla-Costa R, Pincerati MR, Beltrame MH, Malheiros D, Petzl-Erler ML. Polymorphisms In the 2q33 and 3q21 Chromosome Regions Including T Cell Coreceptor and Ligand Genes May Influence Susceptibility to Pemphigus Foliaceus. Hum Immunol. Apr 27 2010;[Medline].

  17. Shelly S, Agmon-Levin N, Altman A, Shoenfeld Y. Thymoma and autoimmunity. Cell Mol Immunol. Feb 14 2011;[Medline].

  18. Bastuji-Garin S, Souissi R, Blum L, et al. Comparative epidemiology of pemphigus in Tunisia and France: unusual incidence of pemphigus foliaceus in young Tunisian women. J Invest Dermatol. Feb 1995;104(2):302-5. [Medline].

  19. Warren SJ, Lin MS, Giudice GJ, et al. The prevalence of antibodies against desmoglein 1 in endemic pemphigus foliaceus in Brazil. Cooperative Group on Fogo Selvagem Research. N Engl J Med. Jul 6 2000;343(1):23-30. [Medline].

  20. Fariba G, Ayatollahi A, Hejazi S. Pemphigus foliaceus. Indian Pediatr. Mar 8 2012;49(3):240-1. [Medline].

  21. Metry DW, Hebert AA, Jordon RE. Nonendemic pemphigus foliaceus in children. J Am Acad Dermatol. Mar 2002;46(3):419-22. [Medline].

  22. Daoud YJ, Foster CS, Ahmed R. Eyelid skin involvement in pemphigus foliaceus. Ocul Immunol Inflamm. Sep-Oct 2005;13(5):389-94. [Medline].

  23. Uzun S, Durdu M. The specificity and sensitivity of Nikolskiy sign in the diagnosis of pemphigus. J Am Acad Dermatol. Mar 2006;54(3):411-5. [Medline].

  24. Grekin SJ, Fox MC, Gudjonsson JE, Fullen DR. Psoriasiform pemphigus foliaceus: a report of two cases. J Cutan Pathol. Jan 10 2012;[Medline].

  25. Brenner S, Ruocco V. D-penicillamine-induced pemphigus foliaceus with autoantibodies to desmoglein-1. J Am Acad Dermatol. Jul 1998;39(1):137-8. [Medline].

  26. Olszewska M, Misiewiz J, Kolakowska-Starzyk H. Penicillamine-induced pemphigus herpetiformis (foliaceus). Dermatol Klin (Wroclaw). 2001;3 (Suppl 1):101.

  27. Lin R, Ladd DJ Jr, Powell DJ, Way BV. Localized pemphigus foliaceus induced by topical imiquimod treatment. Arch Dermatol. Jul 2004;140(7):889-90. [Medline].

  28. Fujita H, Iguchi M, Watanabe R, Asahina A. Pemphigus foliaceus induced by bucillamine. Eur J Dermatol. Jan-Feb 2007;17(1):98-9. [Medline].

  29. Kraigher O, Wohl Y, Gat A, Brenner S. A mixed immunoblistering disorder exhibiting features of bullous pemphigoid and pemphigus foliaceus associated with Spirulina algae intake. Int J Dermatol. Jan 2008;47(1):61-3. [Medline].

  30. Jarzabek-Chorzelska M, Jablonska S, Kolacinska-Strasz Z, Sulej I. Immunopathological diagnosis of pemphigus foliaceus. Dermatology. 2002;205(4):413-5; author reply 415-6; discussion 416. [Medline].

  31. Kumaresan M, Rai R, Sandhya V. Immunofluorescence of the outer root sheath: an aid to diagnosis in pemphigus. Clin Exp Dermatol. Dec 24 2010;[Medline].

  32. Harman KE, Gratian MJ, Seed PT, Bhogal BS, Challacombe SJ, Black MM. Diagnosis of pemphigus by ELISA: a critical evaluation of two ELISAs for the detection of antibodies to the major pemphigus antigens, desmoglein 1 and 3. Clin Exp Dermatol. May 2000;25(3):236-40. [Medline].

  33. Martel P, Gilbert D, Labeille B, Kanitakis J, Joly P. A case of paraneoplastic pemphigus with antidesmoglein 1 antibodies as determined by immunoblotting. Br J Dermatol. Apr 2000;142(4):812-3. [Medline].

  34. Narbutt J, Sysa-Jedrzejowska A, Torzecka JD. The usefulness of enzyme-linked immunosorbent assay for serodiagnosis of pemphigus vulgaris and pemphigus foliaceus at various stages of diseaseactivity. Przegl Dermatol. 2002;89:447-452.

  35. Nagao K, Tanikawa A, Yamamoto N, Amagai M. Decline of anti-desmoglein 1 IgG ELISA scores by withdrawal of D-penicillamine in drug-induced pemphigus foliaceus. Clin Exp Dermatol. Jan 2005;30(1):43-5. [Medline].

  36. Martin LK, Werth V, Villanueva E, Segall J, Murrell DF. Interventions for pemphigus vulgaris and pemphigus foliaceus. Cochrane Database Syst Rev. Jan 21 2009;CD006263. [Medline].

  37. Grando SA. New approaches to the treatment of pemphigus. J Investig Dermatol Symp Proc. Jan 2004;9(1):84-91. [Medline].

  38. Murrell DF, Dick S, Ahmed AR, et al. Consensus statement on definitions of disease, end points, and therapeutic response for pemphigus. J Am Acad Dermatol. Jun 2008;58(6):1043-6. [Medline].

  39. Dumas V, Roujeau JC, Wolkenstein P, Revuz J, Cosnes A. The treatment of mild pemphigus vulgaris and pemphigus foliaceus with a topical corticosteroid. Br J Dermatol. Jun 1999;140(6):1127-9. [Medline].

  40. Gupta R. Prolonged remission of pemphigus induced by dexamethasone-cyclophosphamide pulse therapy. Indian J Dermatol Venereol Leprol. Mar-Apr 2007;73(2):121-2. [Medline].

  41. Katz KH, Marks JG Jr, Helm KF. Pemphigus foliaceus successfully treated with mycophenolate mofetil as a steroid-sparing agent. J Am Acad Dermatol. Mar 2000;42(3):514-5. [Medline].

  42. Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol. Jun 1993;28(6):998-1000. [Medline].

  43. Herr AL, Hatami A, Kokta V, Dalle JH, Champagne MA, Duval M. Successful anti-CD20 antibody treatment of pemphigus foliaceus after unrelated cord blood transplantation. Bone Marrow Transplant. Feb 2005;35(4):427-8. [Medline].

  44. [Best Evidence] Amagai M, Ikeda S, Shimizu H, et al. A randomized double-blind trial of intravenous immunoglobulin for pemphigus. J Am Acad Dermatol. Apr 2009;60(4):595-603. [Medline].

  45. Toth GG, Jonkman MF. Successful treatment of recalcitrant penicillamine-induced pemphigus foliaceus by low-dose intravenous immunoglobulins. Br J Dermatol. Sep 1999;141(3):583-5. [Medline].

  46. Martin LK, Werth VP, Villaneuva EV, Murrell DF. A systematic review of randomized controlled trials for pemphigus vulgaris and pemphigus foliaceus. J Am Acad Dermatol. Feb 24 2011;[Medline].

  47. Daniel BS, Murrell DF. The actual management of pemphigus. G Ital Dermatol Venereol. Oct 2010;145(5):689-702. [Medline].

  48. Marzano AV, Fanoni D, Venegoni L, Berti E, Caputo R. Treatment of refractory pemphigus with the anti-CD20 monoclonal antibody (rituximab). Dermatology. 2007;214(4):310-8. [Medline].

  49. Alter M, Wittmann M, Volker B, Kapp A, Werfel T, Gutzmer R. [Successful treatment of pemphigus foliaceus with rituximab : Report of 3 cases.]. Hautarzt. Jan 18 2009;[Medline].

  50. Lolis M, Toosi S, Czernik A, Bystryn JC. Effect of intravenous immunoglobulin with or without cytotoxic drugs on pemphigus intercellular antibodies. J Am Acad Dermatol. Mar 2011;64(3):484-9. [Medline].

  51. Gee SN, Velez NF, Sepehr A, Burgin S. Two distinct viral infections complicating pemphigus foliaceus. Dermatol Online J. Jan 15 2012;18(1):3. [Medline].

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Middle-aged American woman of Mexican lineage with superficial bullae characteristic of pemphigus foliaceus.
Pemphigus foliaceus. Middle-aged American woman of Mexican lineage with superficial bullae formation.
A 41-year-old woman of Puerto Rican origin with a 9-year history of pemphigus foliaceus, often with erythroderma flares.
A 41-year-old woman of Puerto Rican origin with a 9-year history of pemphigus foliaceus, often with erythroderma flares.
Histologic view shows the typical pattern of a detached stratum corneum without bullae formation. Pigmentary incontinence is prominent in the dermis, reflecting the patient's 9-year history of recurrent superficial bullae.
 
 
 
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