History:

A 58-year -old male patient , farmer by occupation presented with a 10-year history of recurrent partially defined erythematous crusted patches involving the trunk and thighs.  The patient is otherwise healthy, with no history of systemic diseases or current medications. Examination showed multiple erythematous scally and crusted mildly pruritic partially defined patches on the trunk and thighs. No mucous membranes affection. The case had been misdiagnosed by another dermatologist as as tinea incognito !!! However, skin biopsy revealed subcorneal acantholysis with esinophilia, a picture consistent with pemphigus foliaceous. IF studies couldn't be done due to financial cause. The patient showed significant improvement on topical clobetasole propoionate 0.05% cream twice per day. The patient , then, missed to follow up.

 

This case is owned and submitted by Dr. Ayman Abdelmaksoud, M.D., Egypt.