A 30-year-old male patient with no morbid history or history of drug use.
She presented with a 5-month history of pruritic and crusted plaques on her scalp, with subsequent extension of crusted erosions to the extremities and extremities.
Culture of lesions was performed, which was positive for T. rubrum.
1.
He initially received ciprofloxacin, mupirocin and topical terbinafine with poor response.
Oral terbinafine and prednisone were then started for presumptive diagnosis of inflammatory tin capitis.
The patient was monitored at 2 weeks, highlighting dorsum of new foot erosion with weaned surface without mucosal involvement.
Laboratory tests showed leukocytosis of 12,500 cells/mm3 without left shift and ESR 14 mmHr.
Due to suspicion of bullous disease, a skin biopsy with direct immunofluorescence (DIF) was requested, which showed extensive loss of epidermis due to intraepidermal blister acantholysis, supradermal.
DFA was positive for C3 and intercellular and epidermal IgG, and negative for IgA, IgM and fibrin.
1.
Clinical and laboratory findings were compatible with pemphigus vulgaris without mucosal involvement.
Treatment was initiated with prednisone 1 mg/kg/day for 30 days with excellent response and capillary repopulation of the scalp.
A gradual decrease of prednisone was performed, entering the phase of non recurrence of lesions.
