Diagnosis: Pemphigus foliaceus
Description: Note the red eroded areas on this lady's back The blisters were very superficial and burst easily.
Morphology: Erosions
Site: Back
Sex: F
Age: 75
Type: Clinical
Submitted By: Ian McColl
Differential DiagnosisHistory:
Elderly patients with an eroded itchy back and crusts may be thought to have infected eczema but keep pemphigus foliaceous in the back of your mind as another possible diagnosis. Unlike pemphigus vulgaris there will be no oral lesions.
Do an incisional biopsy across a lesion edge and another for direct immunofluorescence.