title: An unusual case of pemphigus vulgaris presenting as bilateral foot ulcers.
abstract: We describe an unusual presentation of pemphigus vulgaris, an autoimmune intraepidermal blistering skin disease associated with autoantibodies to the desmosome glycoprotein, desmoglein 3. A 60-year-old man presented with bilateral ulceration on the dorsum of the feet. These clinical features persisted for 4 months before more characteristic signs of pemphigus vulgaris, including mouth ulceration and skin erosions, developed. The atypical presentation led to a delay in diagnosis and initiation of the appropriate treatment. Pemphigus vulgaris may have unusual manifestations, such as nail dystrophy, paronychia, or granulation tissue-like lesions, but this case of bilateral foot ulceration highlights a further, perhaps unique, clinical presentation of this autoimmune disease.
authors.affiliation: National Skin Centre, Singapore.
authors.forename: H H
authors.initials: HH
authors.lastname: Tan
authors.forename: Y K
authors.initials: YK
authors.lastname: Tay
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003622:Dapsone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000150:complications* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D003622:Dapsone; D011239:Prednisolone