title: Pemphigus foliaceus.
abstract: A 55-year-old woman presented after a four-year history of impetiginized eczema that was distributed over her face, scalp, chest, and back and a recent diagnosis of breast cancer. A skin biopsy specimen for direct immunofluorescence demonstrated intercellular IgG4. Anti-desmoglein 1 and 3 antibodies were present. Indirect immunofluorescence testing was positive on monkey but not rat esophagus. These findings were consistent with a diagnosis of pemphigus foliaceus in association with a malignant condition. After many years of the use of topical glucocorticoids and oral antibiotics, the patient's disease was ultimately managed with methotrexate and a small dose of prednisone. Increasing data supports a role for a steroid-sparing effect of methotrexate in pemphigus vulgaris and likely pemphigus foliaceus.
authors.affiliation: New York University School of Medicine.
authors.forename: Charisse M
authors.initials: CM
authors.lastname: Orne
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hale
authors.forename: Shane A
authors.initials: SA
authors.lastname: Meehan
authors.forename: Marie
authors.initials: M
authors.lastname: Leger
mesh_terms: D001943:Breast Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000150:complications / Q000276:immunology / Q000473:pathology*; D010392:Pemphigus / Q000150:complications / Q000276:immunology / Q000473:pathology*
chemical_list: D007074:Immunoglobulin G