Cerebriform Cutaneous Lesions in Pemphigus Vegetans

Abstract

Pemphigus vegetans is an autoimmune bullous disorder characterized by vegetating lesions commonly over the flexures. A 42-year-old female patient came with pemphigus vegetans presenting with interesting cerebriform morphology of the cutaneous lesions over the flexures. Cerebriform tongue, a morphology with typical pattern of sulci and gyri over dorsum of the tongue is a well-known sign seen in pemphigus vegetans. Interestingly, we noticed the typical sulci and gyri pattern in the skin lesions of pemphigus vegetans over the flexures of the body. This clinical sign can be used as a clue in the diagnosis of pemphigus vegetans. Morphology and physical characteristics are important for the diagnosis of the disease. Clinical signs always give a clue to the probable or possible diagnosis in most of the dermatological conditions.

Keywords: Cerebriform; cutaneous; eosinophils; pemphigus vegetans.

Figure 1

Cerebriform cutaneous lesions over the groin and labia majora

Figure 2

Cerebriform cutaneous lesions over the left axilla

Figure 3

Cerebriform tongue

Figure 4

Low power view showing suprabasal bulla (H and E, ×10)

Figure 5

High power view showing acantholytic cells admixed with neutrophils and eosinophils (H and E, ×40)