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We certainly appreciate Dr Forman's interest in our article and his continuing efforts to unravel a controversy that has existed for nearly a century.The historical background for this discussion has been amply covered, both in our article and Dr Forman's letter. That a difference exists between pemphigus vegetans of Neumann and pemphigus vegetans of Hallopeau is certain. Pemphigus vegetans of Hallopeau has a benign course, a lack of bullae, a preference for flexural areas, and a sequence of pustules followed by vegetations, whereas pemphigus vegetans of Neumann usually begins and ends as pemphigus vulgaris, from which it differs only in that many denuded areas heal with papillomatous formations. Its prognosis is similar to pemphigus vulgaris. The controversy boils down to whether pemphigus vegetans of Hallopeau and pyodermite végétante (pyoderma vegetans) are separate diseases. That Hallopeau's name is often associated with both entities certainly doesn't help matters.Dr
NELSON CG. Pemphigus Vegetans of Hallopeau-Reply. Arch Dermatol. 1978;114(4):628. doi:10.1001/archderm.1978.01640160093043