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July 1993

Juvenile Pemphigus Foliaceous: Response to Dapsone

Author Affiliations

Department of Dermatology Southland Hospital Kew, Invercargill, New Zealand

Arch Dermatol. 1993;129(7):910. doi:10.1001/archderm.1993.01680280100026

To the Editor.—  Pemphigus foliaceous of childhood is an exceedingly rare disease. In 1987 Bao-Tian and Piamphongsant1 cited 12 cases in the English-language literature. In this communication, we describe a 12-year-old girl with pemphigus foliaceous. We also report a prompt response to dapsone therapy, thus avoiding oral corticosteroids or the use of cytotoxic drugs.

Report of a Case.—  A 12-year-old New Zealand girl presented with a painful erosion involving most of the right buttock and infected erosions on the fingers of the left hand and the right knee. Wound swab repeatedly yielded Staphylococcus aureus. Histologic examination of the buttock lesion showed a psoriasiform dermatitis reaction. The clinical presentation was puzzling, and a tentative diagnosis of staphylococcal scalded skin syndrome was made. Flucloxacillin therapy was started with some clinical improvement.Three weeks later, she presented again with four fresh intact bullae localized to the anterior surface of her legs. Nikolsky's

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