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Pemphigus Foliaceous

Pemphigus foliaceus affects people of all races, age and sex and usually otherwise in good health. It appears most commonly between the ages of 50-60 years. Pemphigus foliaceus is sometimes provoked by sun exposure.

Pemphigus foliaceus usually begins with small (approximately 1 cm), very itchy and crusty lesions resembling corn flakes on the upper torso and face. The crusts are easily removed, leaving sore ulcers and a burning sensation or localised pain.

Over weeks to months, the condition progresses, with an increasing number of lesions appearing on the upper torso, face, and scalp. In extensive cases, lesions develop over the entire body, become confluent, and can progress to an ‘exfoliative erythroderma’.

Pemphigus foliaceus is characterised by blistering lesions on otherwise healthy-looking skin and is confined to the skin with little or no involvement of the mucous membranes.

Although pemphigus foliaceus is often less severe than Pemphigus Vulgaris, the doses of medications required for control are similar (although some patients may be treated with drugs like dapsone, and may not require corticosteroids or immunosuppressives).


There are currently 6 known variations of Pemphigus Foliaceus:
  • Pemphigus erythematosus

  • Pemphigus herpetiformis

  • Endemic pemphigus foliaceus

  • IgA pemphigus foliaceus

  • Paraneoplastic pemphigus foliaceus

  • Drug-induced pemphigus foliaceus

Penicillamine, nifedipine, captopril, enalapril or nonsteroidal anti-inflammatory drugs can provoke drug-induced pemphigus foliaceus. If the drug is stopped, there is a 50% chance the pemphigus foliaceus will clear up.

DermNet NZ is a good source of further information about Pemphigus Foliaceus.

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