Pemphigus foliaceus presenting as eruptive seborrheic keratosis and responding to oral gold treatment.
Pemphigus Foliaceus (PF) is an antibody-mediated autoimmune disease. IgG directed against desmoglein-1 induces acantholysis in the superficial epidermis, leading to the classic presentation of crusted erosions in a seborrheic distribution. We report a case of a 51-year-old African-American man with an 8-year history of PF, who developed multiple hyperpigmented, 'stuck-on' appearing verrucous papules and plaques on the back, chest, and neck. Skin biopsy and direct immunofluorescence from the seborrheic keratosis-like lesions was consistent with pemphigus foliaceus. The patient was treated by adding oral gold (auranofin) to his regimen of prednisone and discontinuing hydroxychloroquine. After six months of follow-up his erosions healed. This is the first report of treating pemphigus foliaceus with oral gold.
Bagheri
Mohammed M
MM
Department of Dermatology, New York Medical College (A), Valhalla, New York, USA.
Alagheband
Mehran
M
Memar
Omeed M
OM
Eiler
David B
DB
D001310:Auranofin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D007642:Keratosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000175:diagnosis* / Q000188:drug therapy
D001310:Auranofin