Transition from Pemphigus Foliaceus to Pemphigus Vulgaris: Case Report with Literature Review.
10.3349/ymj.2006.47.2.278
- Author:
Sang Gun PARK
1
;
Jae Yong CHANG
;
Young Hun CHO
;
Soo Chan KIM
;
Min Geol LEE
Author Information
1. Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, BK21 Project for Medical Science, Yonsei University, Seoul, Korea. mglee@yumc.yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Pemphigus;
western blotting
- MeSH:
Time Factors;
Steroids/therapeutic use;
Skin/pathology;
Pemphigus/*diagnosis/pathology;
Middle Aged;
Male;
Immunoglobulin G/chemistry;
Immunoblotting;
Humans;
Fluorescent Antibody Technique, Indirect;
Female;
Disease Progression;
Cell Membrane/metabolism;
Blotting, Western;
Azathioprine/therapeutic use;
Autoantigens/chemistry;
Autoantibodies/chemistry;
Aged;
Adult
- From:Yonsei Medical Journal
2006;47(2):278-281
- CountryRepublic of Korea
- Language:English
-
Abstract:
The transition between the main subtypes of pemphigus, pemphigus vulgaris (PV), and pemphigus foliaceus (PF) has rarely been reported. Moreover, the development of PV in a patient with PF is much more unusual than that of PF in a patient with PV. We report a 48-year-old man who presented with cutaneous lesions showing the typical clinical and histological features of PF. Five years later, his skin lesions became extensive and he developed oral erosions. His condition did not respond well to steroids and azathioprine. Histological examination of a vesicle disclosed suprabasal acantholysis in contrast to the subcorneal acantholysis discovered upon initial histological evaluation. Indirect immunofluorescence revealed IgG antikeratinocyte cell surface antibodies at a titer of 1:640. The titer was 1:160 at initial diagnosis. Upon immunoblotting, the patient's serum reacted with 130 kiloDalton (kDa) and 160 kDa proteins, suggesting desmoglein (Dsg) 3 and 1, respectively. We herein report an unusual case of PV that developed from PF during the disease's flare-up.
