II. Definition

  1. Less common, milder and superficial form of Pemphigus

III. Signs

  1. Onset on skin of face in butterfly distribution
  2. May also involve scalp, chest or upper back
  3. Rarely involves Oral Mucosa
  4. Nikolsky's Sign absent

IV. Variants

  1. Pemphigus erythematosus (Senear-Usher Syndrome)
    1. Localized variant of Pemphigus Foliaceus
    2. Associated with Systemic Lupus Erythematosus
    3. Antinuclear Antibody positive
  2. Fogo selvagem
    1. Variant of Pemphigus Foliaceus
    2. Endemic to Brasil and Colombia
    3. Associated with chronic Black Fly exposure
  3. Pemphigus herpetiformis
    1. Pruritic Blister formation
    2. May appear similar to Dermatitis Herpetiformis
  4. Drug-Induced Pemphigus
    1. Associated with Penicillamine and Captopril
    2. Differentiate from Drug-Triggered Pemphigus
      1. Unmasks Pemphigus Vulgaris

V. Labs: Histology

  1. Blister forms just below Stratum Corneum of Epidermis

VI. References

  1. Habif (1996) Clinical Dermatology, Mosby, p. 510
  2. Cotell (2000) Am J Emerg Med 18(3):288-99 [PubMed]

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