title: Localized pemphigus foliaceus exclusively involving the follicular infundibulum: a novel peau d'orange appearance.
abstract: Localized pemphigus foliaceus (PF) clinically presents as red plaques with scale and crust due to acantholysis of the epidermis. The follicular infundibulum shows acantholysis, but usually with epidermal acantholysis or at least erosion. Localized PF exclusively involving the follicular infundibulum, which shows a peau d'orange appearance, has never been reported. We describe a patient with a red plaque and peau d'orange appearance on the cheek for 20 years. Dyskeratotic acantholysis in the follicular infundibulum was overlooked when the first biopsy specimen was obtained, and a disseminated lesion developed soon after, which led to the diagnosis. Although a peau d'orange appearance is a rare clinical manifestation of PF, PF should be considered as the differential diagnosis on the basis of this appearance, especially when the lesion persists on the face for long periods.
authors.affiliation: Department of Dermatology, Ikeda Munipal Hospital, Osaka, Japan. bboohay02@ybb.ne.jp
authors.forename: Chika
authors.initials: C
authors.lastname: Ohata
authors.forename: Kana
authors.initials: K
authors.lastname: Akamatsu
authors.forename: Naho
authors.initials: N
authors.lastname: Imai
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Sumimura
mesh_terms: D000051:Acantholysis / Q000175:diagnosis / Q000209:etiology*; D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D005148:Facial Dermatoses / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010392:Pemphigus / Q000150:complications / Q000175:diagnosis*; D012867:Skin / Q000473:pathology*