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April 1990

Pemphigus Erythematosus Resembling Multiple Seborrheic Keratoses

Author Affiliations

Department of Dermatology

Department of Pathology Kalafong Hospital Private Bag X396 Pretoria 0001, Republic of South Africa

Arch Dermatol. 1990;126(4):543-544. doi:10.1001/archderm.1990.01670280129034

To the Editor.—  Superficial pemphigus, whether of the erythematous or foliaceous kind, may simulate other dermatoses such as lupus erythematosus or seborrheic dermatitis.We describe a patient in whom pemphigus erythematosus presented clinically as multiple seborrheic keratoses. There are two recent reports on the clinical presentation of pemphigus foliaceous.1,2

Report of a Case.—  A 56-year-old black man had a 10-year history of intermittent treatment for superficial pemphigus. Over the last 2 years, as his bullous disease had become more benign, hyperpigmented, warty lesions gradually developed on his back and chest. He was in good health, and the abnormal physical findings were confined to the skin. Over the back and upper extremities, there were numerous well-defined, raised, hyperpigmented, hyperkeratotic lesions ranging in diameter from 1 to 3 cm. The lesions on the back tended to follow the lines of skin cleavage and had an elongated shape (Fig 1). Most lesions

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