Pemphigus foliaceus presenting as eruptive seborrheic keratosis and responding to oral gold treatment
Bagheri, M.M.; Alagheband, M.; Memar, O.M.; Eiler, D.B.
Journal of Drugs in Dermatology Jdd 1(3): 333-334
2002
ISSN/ISBN: 1545-9616 PMID: 12851996 Document Number: 9577
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.
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