Diagnosis: Pemphigus foliaceus
Description: You can see the remains of the blister roof as the ragged edges to some of these annular lesions
Morphology: Erosions
Site: Back
Sex: F
Age: 75
Type: Clinical
Submitted By: Ian McColl
Differential Diagnosis
History:
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.