Ann Dermatol.  2011 Dec;23(Suppl 3):S281-S284. 10.5021/ad.2011.23.S3.S281.

Pemphigus Foliaceus Associated with Psoriasis during the Course of Narrow-Band UVB Therapy: A Simple Coincidence?

• Kwon HH
• Kwon IH
• Chung JH
• Youn JI

• KMID: 2171851
• DOI: http://doi.org/10.5021/ad.2011.23.S3.S281

Abstract

Although psoriasis and bullous diseases are considered to be completely different disease entities, the literature has reported a few cases of psoriasis associated with bullous diseases, most of which are bullous pemphigoid. In limited cases, pemphigus foliaceus has also been reported in association with psoriasis. In most of them, pemphigus lesions usually developed on an untreated patient with a chronic history of psoriasis. Herein, we report a case of 53-year-old male with a chronic history of psoriasis who first developed generalized erosive lesions after 26 cycles of narrow-band ultraviolet B (NBUVB) therapy. A diagnosis of pemphigus foliaceus was made based on skin biopsy and direct immunofluorescence assay. Pemphigus lesions were well controlled with combination therapy of oral steroid and azathioprine. This is the first case where pemphigus foliaceus co-occurred with psoriasis during NBUVB therapy.

Keyword

Narrow-band UVB; Pemphigus foliaceus; Psoriasis

MeSH Terms

Azathioprine
Biopsy
Fluorescent Antibody Technique, Direct
Humans
Male
Middle Aged
Pemphigoid, Bullous
Pemphigus
Psoriasis
Skin
Azathioprine

Figure

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  Fig. 1 (A) Typical nummular type psoriasis at patient's initial visit. (B) Development of flaccid vesicles and erosive lesions after receiving 26 cycles of narrow-band ultraviolet B therapy (Total irradiation dose: 65, 930 mJ).

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  Fig. 2 (A) Acantholysis of the upper epidermis, moderate dermal infiltration of lymphocytes from erosive lesions (H&E, ×200). (B) Direct immunofluorescence on perilesional tissue showing intercellular IgG deposition.

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