title: Physically induced pemphigus after cosmetic procedures.
abstract: BACKGROUND
  Pemphigus is a vesiculobullous autoimmune disease characterized by acantholysis due to antibodies against epidermal antigens.
  
  
  METHODS
  We report the first two cases of pemphigus in which lesions appeared in areas traumatized by cosmetic procedures. In one case, the patient had a history of pemphigus under excellent control; pemphigus lesions appeared only in her surgical scars 2 months after a reduction mammoplasty and facelift. The other patient presented with an outbreak of pemphigus 4 weeks after a chemical peel.
  
  
  CONCLUSIONS
  Physical agents including infrared and ionizing radiation as well as ultraviolet light are known triggers of pemphigus. We suggest that cosmetic procedures can initiate pemphigus and that this change must be differentiated from postoperative wound infections and other reasons for poor wound healing.
authors.affiliation: Division of Dermatology, University of California, Los Angeles School of Medicine.
authors.forename: R P
authors.initials: RP
authors.lastname: Kaplan
authors.forename: S P
authors.initials: SP
authors.lastname: Detwiler
authors.forename: H W
authors.initials: HW
authors.lastname: Saperstein
mesh_terms: D000368:Aged; D002615:Chemexfoliation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D010392:Pemphigus / Q000175:diagnosis / Q000209:etiology*; D015361:Rhytidoplasty / Q000009:adverse effects*