title: Pemphigus foliaceus presenting as eruptive seborrheic keratosis and responding to oral gold treatment.
abstract: 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.
authors.affiliation: Department of Dermatology, New York Medical College (A), Valhalla, New York, USA.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Bagheri
authors.forename: Mehran
authors.initials: M
authors.lastname: Alagheband
authors.forename: Omeed M
authors.initials: OM
authors.lastname: Memar
authors.forename: David B
authors.initials: DB
authors.lastname: Eiler
mesh_terms: 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
chemical_list: D001310:Auranofin