Pemphigus Erythematosus Clinical Presentation

Updated: Mar 02, 2018
  • Author: Rakesh Bharti, MD, AAHIVS; Chief Editor: William D James, MD  more...
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Onset and progression of pemphigus erythematosus are typically slow. Although the distribution of the pemphigus erythematosus lesions should suggest induction by sunlight, the patient may be completely unaware of the photosensitive nature of the disorder.


Physical Examination

Pemphigus erythematosus lesions typically involve the scalp, the face, the upper part of the chest, and the back. [6] Patients with classic pemphigus erythematosus present with small, flaccid bullae with scaling and crusting. Occasionally, the appearance may suggest a papulosquamous disorder. On the face, pemphigus erythematosus presents on the bridge of the nose and on the malar areas as in the butterfly distribution seen in LE.

Secondary infection may occur, resulting in impetiginization, in healing with pigment changes, and in scarring.

With extensive involvement, pemphigus erythematosus patients may present with an exfoliative erythroderma. The skin may be tender. Patients with pemphigus erythematosus do not typically develop mucous membrane involvement. Electrolyte imbalance and loss of temperature control can occur with extensive skin involvement.