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    The Value of Direct Immunofluorescence on Proteinase-Digested Formalin-Fixed Paraffin-Embedded Skin Biopsies.
    Am J Dermatopathol 2017 Aug 9. Epub 2017 Aug 9.
    Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA.
    Direct immunofluorescence (DIF) on frozen tissue (DIF-F) is the method of choice for the identification of immune deposits present in skin and other tissues. DIF can also be performed on formalin-fixed paraffin-embedded tissue (DIF-P) after antigen retrieval with proteases and has proven to be of value in renal pathology. However, its utility in skin biopsies has not been fully examined. Read More


    Th1 polarizing γδ-T cells and Scavenger Receptors contribute to the pathogenesis of Pemphigus Vulgaris.
    Immunology 2017 Aug 16. Epub 2017 Aug 16.
    Department of Biochemistry, All India Institute of Medical Sciences, New Delhi.
    Gamma delta T cells (γδ T cells) and Scavenger receptors are key innate immune machinery playing significant role in regulating immune homeostasis at epithelial surface. The roles of these immune components are not yet characterized for the autoimmune skin disorder Pemphigus Vulgaris (PV). Phenotyping and frequency of γδ T cells estimated by Flowcytometry has shown increased frequency of γδ T cells (6. Read More

    Paraneoplastic Pemphigus. A Life-Threatening Autoimmune Blistering Disease.
    Actas Dermosifiliogr 2017 Aug 8. Epub 2017 Aug 8.
    Servicio de Dermatología, Hospital General de México, Mexico.
    Paraneoplastic pemphigus (PNP), a subset of pemphigus, is a unique autoimmune blistering condition that can affect multiple organs other than the skin. It is a life-threatening disease associated with an underlying malignancy, most commonly of lymphoproliferative origin. The clinical picture may resemble pemphigus, pemphigoid, erythema multiforme, graft-versus-host disease, or lichen planus. Read More

    Oral pemphigus vulgaris: Liquid-based cytological findings and pitfalls.
    Diagn Cytopathol 2017 Aug 11. Epub 2017 Aug 11.
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
    Pemphigus vulgaris (PV) is a chronic autoimmune bullous disease characterized by the formation of suprabasal cleavage and acantholysis. As this disease almost always affects the oral mucosa, conventional cytological smears of oral lesions can be used for the initial diagnosis of PV. We report two cases of PV that were initially diagnosed based on cytological smears of an oral sample. Read More

    Autoimmune Bullous Disease in Childhood.
    Indian J Dermatol 2017 Jul-Aug;62(4):440
    Department of Dermatology, School of Medicine, Marmara University, Istanbul, Turkey.
    Background: Autoimmune bullous disorders (AIBDs) are a heterogeneous group of diseases which are rarely seen in children. Studies concerning the immunobullous diseases in pediatric patients are scarce.

    Aims And Objectives: In this study, we aimed to investigate the clinical features and treatment outcomes of AIBDs in children. Read More

    Dermatoscopy in Diagnosis of Cutaneous Myiasis Arising in Pemphigus Vulgaris Lesions.
    Indian J Dermatol 2017 Jul-Aug;62(4):440
    Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
    Myiasis, infestation of live human and vertebrate animals by larvae, can complicate ulcers and open wounds. Although myiasis occurs in neglected erosions of pemphigus, such a complication is not documented in the literature. Herein, we report a case of myiasis complicating pemphigus vulgaris and describe its dermatoscopic features. Read More

    Refractory pemphigus foliaceus associated with herpesvirus infection: case report.
    Rev Inst Med Trop Sao Paulo 2017 3;59:e41. Epub 2017 Aug 3.
    Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Laboratório de Virologia, Rio de Janeiro, Rio de JaneiroBrasil.
    Pemphigus foliaceus (PF) is an autoimmune disease characterized by blistering of the skin. Infections caused by members of the herpesviridae family have been suggested as a possible triggering factor for pemphigus vulgaris (PV), but not for PF. The present study aimed to investigate the presence of Human herpesvirus (types 1, 2, 3) in corticosteroid refractory skin lesions from a patient with PF, by a Polymerase chain reaction (PCR) assay. Read More

    Achievement of the longest survival of paraneoplastic pemphigus with bronchiolitis obliterans associated with follicular lymphoma using R-CHOP chemotherapy.
    Int J Hematol 2017 Aug 8. Epub 2017 Aug 8.
    Department of Hematology, Japan Red Cross Fukui Hospital, 2-4-1 Tsukimi, Fukui, Fukui, 918-8501, Japan.
    Paraneoplastic pemphigus (PNP) is a rare, fatal, paraneoplastic autoimmune mucocutaneous blistering disease, commonly associated with lymphoproliferative disorders, including malignant lymphomas. Lymphoproliferative disorders associated with PNP are sometimes associated with a serious lung complication, bronchiolitis obliterans (BO). Due to its rarity, guidelines for the management of PNP have not been established. Read More

    On the role of IgG4 in inflammatory conditions: lessons for IgG4-related disease.
    Biochim Biophys Acta 2017 Aug 4. Epub 2017 Aug 4.
    Department of Gastroenterology & Hepatology, Tytgat Institute for Liver and Intestinal Research, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. Electronic address:
    The pathophysiology of immunoglobulin G4-related disease (IgG4-RD) and its most common manifestations, IgG4-associated (sclerosing) cholangitis and autoimmune pancreatitis, remains largely unknown, but IgG4 is presumably involved. IgG4 is a promiscuous antibody, which could be directly pathogenic, fulfill a protective role, or could just be a fortuitous marker of an aberrant inflammatory response. IgG4 antibodies possess exclusive structural and functional characteristics suggesting anti-inflammatory and tolerance-inducing effects. Read More

    Dermoscopic and reflectance confocal microscopic presentation of Hailey-Hailey disease: A case series.
    Skin Res Technol 2017 Aug 7. Epub 2017 Aug 7.
    Department of Dermatology, Hospital de Santa Maria, Lisbon, Portugal.
    Background/purpose: Hailey-Hailey disease is a rare inherited acantholytic skin disorder characterized by heterogeneous clinical presentation. Its differential diagnosis might be wide, including other genodermatoses, inflammatory, and infectious skin diseases. Although histopathology remains as diagnostic gold standard, noninvasive techniques such as dermoscopy and reflectance confocal microscopy may assist clinical examination. Read More

    Low-Dose Naltrexone Treatment of Familial Benign Pemphigus (Hailey-Hailey Disease).
    JAMA Dermatol 2017 Aug 2. Epub 2017 Aug 2.
    Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio2Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio.
    Importance: Familial benign pemphigus, or Hailey-Hailey disease (HHD), is a rare and debilitating genetic dermatosis characterized by chronic, recurrent vesicles, erosions, and maceration in flexural areas. Despite the reported therapeutic modalities, such as topical and systemic corticosteroids, systemic immunomodulators, topical and systemic retinoids, and laser, HHD can still be markedly difficult to control.

    Objective: To assess low-dose naltrexone hydrochloride in the treatment of recalcitrant HHD. Read More

    Pemphigus foliaceus as a differential diagnosis in vesicobullous lesions.
    Einstein (Sao Paulo) 2017 Apr-Jun;15(2):220-222
    Faculdade de Medicina de Jundiaí, Jundiaí, SP, Brazil.
    Given the challenge of clinical diagnosis of bullous skin lesions, this report aimed to discuss the histological changes, the presentation and clinical reasoning for diagnosis of these lesions. At the same time, the importance of the pathology was reviewed to identify these clinical scenarios. In this case report, we highlighted the clinical progression of a case of pemphigus foliaceus. Read More

    Skin diseases of the vulva: inflammatory, erosive-ulcerating and apocrine gland diseases, zinc and vitamin deficiency, vulvodynia and vestibulodynia.
    J Obstet Gynaecol 2017 Aug 1:1-12. Epub 2017 Aug 1.
    a Department of Dermatology , Bispebjerg Hospital , Copenhagen , Denmark.
    Chronic, inflammatory and ulcerating mucocutaneous diseases that can affect the vulvar area are reviewed: lichen sclerosus, lichen planus, plasma cell vulvitis, complex aphthosis, Behcet's disease, pyoderma gangrenosum, metastatic Crohn's disease, dyskeratotic skin diseases (Hailey-Hailey disease and Darier's disease), autoimmune bullous diseases (mucous membrane pemphigoid and pemphigus vulgaris) and hidradenitis suppurativa. Also, vulvodynia and vestibulodynia, zinc and vitamin B deficiency are described. Read More

    Analysis of Serum Cytokine Profile in Pemphigus.
    Ann Dermatol 2017 Aug 21;29(4):438-445. Epub 2017 Jun 21.
    Department of Dermatology and Cutaneous Biology Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
    Background: Pemphigus is a group of autoimmune blistering diseases affecting skin and mucous membranes. While pemphigus is an autoantibody mediated disease, the role of T cells and cytokines in the pathogenesis is being increasingly recognized.

    Objective: This study was conducted to observe alterations in the serum cytokine levels of patients with pemphigus vulgaris (PV), pemphigus foliaceous (PF), paraneoplastic pemphigus (PNP) and compare with bullous pemphigoid (BP) and healthy subjects. Read More

    Paraneoplastic pemphigus seen in 4 patients with hematologic malignancies formerly treated with rituximab.
    J Eur Acad Dermatol Venereol 2017 Jul 31. Epub 2017 Jul 31.
    Resident of Dermatology, Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
    Paraneoplastic pemphigus (PNP) is a peculiar variant of pemphigus with pathognomonic clinical, histological, and immunological features. It is typically associated with hematologic malignancies (84%), such as non-Hodgkin lymphomas (NHL) (most common), chronic lymphocytic leukemia (CLL), Castleman disease, thymoma, Waldenström's macroglobulinemia, Hodgkin lymphoma, and monoclonal gammopathy, as well as non-hematological neoplasms, such as epithelial carcinomas, mesenchymal sarcomas, and malignant melanoma. This article is protected by copyright. Read More

    PD-1 Inhibitor Associated Lichenoid Inflammation with Incidental Suprabasilar Acantholysis or Vesiculation - Report of Four Cases.
    J Cutan Pathol 2017 Jul 28. Epub 2017 Jul 28.
    Department of Dermatology, Westmead Hospital, Sydney, Australia.
    Background: Immune checkpoint agents targeting Programmed cell death-1 protein (PD1) or Cytotoxic T-Lymphocyte Associated Protein-4 (CTLA-4) receptors are increasingly utilised in treatment of advanced malignancies. However, these immunotherapies are commonly associated with idiosyncratic cutaneous adverse reactions. Thus, recognition and awareness of these reactions are necessary. Read More

    Comorbid autoimmune diseases in patients with pemphigus: a nationwide case-control study in Taiwan.
    Eur J Dermatol 2017 Jul 27. Epub 2017 Jul 27.
    Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan, Department of Dermatology, National Yang-Ming University, Taipei, Taiwan.
    Previous studies have proposed the association between pemphigus and several autoimmune diseases, but no large-scale study has been reported. To delineate the association between pemphigus and autoimmune diseases including psoriasis. A total of 1,998 patients with pemphigus and 7,992 control subjects were enrolled from the National Health Insurance Research Database in Taiwan from 1997 to 2010. Read More

    IgG4, complement, and the mechanisms of blister formation in pemphigus and bullous pemphigoid.
    J Dermatol Sci 2017 Jul 18. Epub 2017 Jul 18.
    Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Singapore Immunology Network (SIgN) and Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore.
    Autoimmune bullous diseases are at the forefront of the research field on autoimmune diseases. Pemphigus and pemphigoid were historical entities in the world of descriptive dermatology for a long time. Recently, however, dermatologists and skin biologists have elegantly explained the novel pathomechanism of pemphigus and pemphigoid diseases. Read More

    Mucocutaneous Diseases: Oral Lichen Planus, Mucous Membrane Pemphigoid and Pemphigus Vulgaris.
    J Calif Dent Assoc 2016 09;44(9):561-70
    Mucocutaneous diseases affect the oral cavity and can present a diagnostic challenge. They can have systemic involvement, necessitating multidisciplinary management. Frequently, patients will see their general dentists initially for evaluation. Read More

    Robotic trans-subxiphoid extended thymectomy in a patient with thymoma-associated pemphigus.
    J Thorac Dis 2017 Jun;9(6):E565-E569
    Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
    We herein firstly reported that a patient with thymoma-associated pemphigus (TAP) underwent a robotic-assisted trans-subxiphoid thoracoscopic extended thymectomy and then achieved stable resolution. The patient, a 47-year-old male, was first admitted to our hospital owing to stomatitis and bullae of the trunk after four months' prednisone treatment. On admission, chest computed tomography (CT) revealed an anterior-mediastinal mass and it was initially diagnosed as a thymoma. Read More

    Appearance of anti-desmocollin 1 autoantibodies leading to a vegetative lesion in a pemphigus vulgaris patient.
    Br J Dermatol 2017 Jul 22. Epub 2017 Jul 22.
    Department of Dermatology, Hokkaido University Graduate School of Medicine,  N15 W7, Kita-ku, Sapporo, 060-8638, Japan.
    Pemphigus is a group of autoimmune bullous diseases that is mainly classified into pemphigus vulgaris (PV) and pemphigus foliaceus.(1) PV is further subcategorized into a mucocutaneous type (with autoantibodies against desmoglein (Dsg) 3 and Dsg1) and a mucosal type (with autoantibodies against Dsg3 but not Dsg1) based on autoantibody profile and clinical features. Pemphigus vegetans (PVeg), a rare variant of PV, is characterized by vegetating lesions. Read More

    NUDT15 polymorphism and severe azathioprine-induced myelosuppression in a Chinese man with pemphigus vulgaris.
    Br J Dermatol 2017 Jul 22. Epub 2017 Jul 22.
    Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, 610041, China.
    Pemphigus vulgaris (PV) is a life-threatening autoimmune muco-cutaneous disease with formidable treatment challenges. Following the first report of successful treatment of PV in 1969 with azathioprine (AZA),(1) which was originally used to treat cancers, and prevent rejection in organ transplantation recipients, AZA has been often used concomitantly with steroids in the treatment of PV. Although generally well tolerated by most patients, AZA can induce severe myelosuppression, especially leucopenia, in some susceptible individuals, thus resulting in serious microbial infections. Read More

    The role of sleep in pemphigus: a review of mechanisms and perspectives.
    Arch Dermatol Res 2017 Jul 19. Epub 2017 Jul 19.
    Departamento de Psicobiologia, Universidade Federal de São Paulo, Napoleão de Barros, 925, Vila Clementino, São Paulo, SP, 04024-002, Brazil.
    Pemphigus is an autoimmune bullous disease that causes the development of blisters and erosions on the skin and/or mucosa. Its inflammatory process is mediated by cytokines, which interact with sleep in a bidirectional manner. Pain, a frequent symptom due to pemphigus lesions, is well known to impair sleep quality. Read More

    A Case Report of Paraneoplastic Pemphigus Associated With Retroperitoneal Inflammatory Myofibroblastic Tumor.
    Acta Med Iran 2017 May;55(5):340-343
    Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
    Paraneoplastic pemphigus (PNP) is an autoimmune bullous disease associated with underlying neoplasms, both malignant and benign. The most constant clinical presentation of PNP is the presence of intractable stomatitis. Herein we present a 25-year-old male with a 3-month history of refractory stomatitis especially involving the lips and widespread vesiculobullous eruption on his trunk and extremities. Read More

    Generalized Discoid Lupus Erythematosus as the Presenting Sign of Small Cell Lung Carcinoma.
    Skinmed 2017 1;15(3):218-220. Epub 2017 Jun 1.
    Department of Dermatology, Mayo Clinic, Rochester, MN.
    A 46-year-old woman with a 30 pack-year smoking history presented with a worsening eruption on the left cheek that failed to improve with metronidazole gel. The cutaneous eruption spread to most of her face and did not respond to a brief tapering course of prednisone. During the initial evaluation at our institution, approximately 6 weeks after the onset of the cutaneous eruption, the patient had erythematous, crusted plaques on her face and scalp (Figure 1A); they were also present on the V-area of the anterior aspect of the neck and upper region of the chest, the shoulders, and the arms, with isolated lesions on the trunk and legs. Read More

    Evaluation of Autoimmune Bullous Diseases in Elderly Patients in Iran: A 10-Year Retrospective Study.
    Skinmed 2017 1;15(3):175-180. Epub 2017 Jun 1.
    Department of Dermatology, Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
    Autoimmune bullous diseases (ABDs) are uncommon but significant skin disorders with relatively high morbidity and mortality. Some surveys have been carried out to describe the spectrum of ABDs in a region, but this is the first that has focused on ABDs in elderly patients. This study was conducted to determine the clinicoepidemiologic features of ABDs in elderly patients. Read More

    Serological diagnostics in the detection of IgG autoantibodies against human collagen VII in epidermolysis bullosa acquisita - a multicenter analysis.
    Br J Dermatol 2017 Jul 13. Epub 2017 Jul 13.
    Department of Dermatology and Allergology, Philipps-University, Marburg, Germany.
    Background: Epidermolysis bullosa acquisita is a rare, potentially devastating autoimmune disease of the skin. IgG autoantibodies directed against type VII collagen (Col7), the major component of anchoring fibrils, induce skin fragility leading to cutaneous and mucocutaneous blister formation which is mostly of a scaring phenotype. Thus, powerful and reproducible diagnostic assays are critical to establish the diagnosis of EBA early to avoid irreversible sequelae. Read More

    Possible role of Helicobacter pylori in diseases of dermatological interest.
    J Biol Regul Homeost Agents 2017 APR-JUN;31(2 Suppl. 2):57-77
    Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
    Helicobacter pylori is a gram-negative, flagellate, microaerophilic bacterium identified for the first time about 30 years ago, as a pathogenic factor of gastritis and peptic ulcer. Soon after, it was linked to several gastrointestinal and extra-gastrointestinal diseases (hematological, cardiovascular, neurological, pulmonary and ocular diseases, obesity, diabetes mellitus, growth retardation and extragastric MALT lymphoma). Association and possible cause-effect correlation with H. Read More

    Mean Platelet Volume in Pemphigus Vulgaris.
    Angiology 2017 Jan 1:3319717718329. Epub 2017 Jan 1.
    3 School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
    Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucous membranes. The mean platelet volume (MPV) is an index of platelet activation reported to be influenced by inflammation. We investigated the MPV in patients with PV relative to controls. Read More

    Reviewing putative industrial triggering in pemphigus: cluster of pemphigus in the area near the wastewater treatment plant.
    Postepy Dermatol Alergol 2017 Jun 29;34(3):185-191. Epub 2017 May 29.
    Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.
    A range of pemphigus is relatively rare potentially fatal group of autoimmune blistering dermatoses. Usually, there is no apparent triggering, while in some predisposed patients there are alleged environmental/industrial inducing factors. In a short time period (4 years), we diagnosed 3 novel cases of pemphigus (1 pemphigus vulgaris, 1 pemphigus foliaceus and 1 shift from pemphigus foliaceus into pemphigus vulgaris) at a clinical and laboratory level (ELISA, immunofluorescence studies). Read More

    [Treatment of Hailey-Hailey disease with botulinic toxin: A retrospective study of 8 cases].
    Ann Dermatol Venereol 2017 Jun 29. Epub 2017 Jun 29.
    Service de dermatologie, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France. Electronic address:
    Background: Hailey-Hailey disease (HHD) is characterised by episodes of weeping erythematous lesions, particularly in areas subject to friction or maceration. Treatment is complex. The value of botulinum toxin has been demonstrated in several studies and in individual cases. Read More

    Evaluating the Efficacy of Double-Filtration Plasmapheresis in Treating Five Patients With Drug-Resistant Pemphigus.
    Ther Apher Dial 2017 Jun;21(3):243-247
    Divisions of Nephrology, Tokyo Teishin Hospital, Tokyo, Japan.
    Double-filtration plasmapheresis is an effective and safe treatment for pemphigus. We retrospectively evaluated the decrease in autoantibody titer and pemphigus disease area index following double-filtration plasmapheresis in five patients with moderate to severe pemphigus, who were physically and/or serologically unresponsive to 1.0 mg/kg per day of prednisolone and other supportive drugs and ointments. Read More

    Selective Plasma Exchange for the Removal of Pemphigus Autoantibodies, Fibrinogen, and Factor XIII in Pemphigus Vulgaris.
    Ther Apher Dial 2017 Jun;21(3):226-231
    Department of Nephrology, Tokyo Medical and Dental University, Tokyo, Japan.
    Pemphigus vulgaris is a serious autoimmune skin disorder associated with desmoglein 1 and 3. Selective plasma exchange (SePE) for pemphigus vulgaris remains unknown. We investigated the removal characteristics of pemphigus autoantibodies, immunoglobulins, and fibrinogen in three cases. Read More

    High-Frequency Ultrasound in Blistering Skin Diseases: A Useful Method for Differentiating Blister Locations.
    J Ultrasound Med 2017 Jun 29. Epub 2017 Jun 29.
    Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.
    Bullous pemphigoid and pemphigus vulgaris, which belong to the group of subepidermal and intraepidermal bullae, respectively, are two potentially devastating blistering skin diseases. We used high-frequency ultrasound (US) in 3 cases of these diseases as prototypes to study the value of high-frequency US in discriminating blister locations. Our findings showed that high-frequency US has a strong correlation with histomorphometric findings because of its high resolution, and we hope that it will be helpful for differentiating blister locations. Read More

    Pivotal Role of Lesional and Perilesional T/B Lymphocytes in Pemphigus Pathogenesis.
    J Invest Dermatol 2017 Jun 21. Epub 2017 Jun 21.
    Department of Dermatology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
    Pemphigus is a skin and mucosal membrane-targeting autoimmune bullous disease. Previous studies have demonstrated that circulating anti-desmoglein1/3 antibodies are pathogenic and mediate blister formation. However, the role of infiltrated immune cells in the lesional skin has not been fully investigated. Read More

    Rituximab administration in a patient with pemphigus vulgaris following reactivation of occult hepatitis B virus infection.
    Dermatol Online J 2017 Jun 20;23(6). Epub 2017 Jun 20.
    Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
    Immunosuppressive drugs are the milestone of treatment of autoimmune diseases, but they can lead to serious complications, including hepatitis B virus reactivation in HBV carriers as well as in patients with occult HBV infection (OBI). A 36-year-old man with OBI was diagnosed with pemphigus vulgaris. He was prescribed prednisolone and his hepatitis B surface antigen turned positive. Read More

    Rituximab in the management of juvenile pemphigus foliaceus.
    Dermatol Online J 2017 Jun 15;23(6). Epub 2017 Jun 15.
    School of Medicine, University of California San Diego, La Jolla, California.
    BackgroundPemphigus foliaceus (PF) is a blistering disorder most commonly presenting in middle age. As PF is restricted to the superficial epidermis, it is considered more benign than other pemphigus diseases. However, progression to severe disease is not uncommon. Read More

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