Pemphigus Vulgaris in a Sexagenarian Male: A Case Report and Review of Literature

Abstract

Pemphigus vulgaris (PV) is a rare autoimmune disorder characterized by mucocutaneous blistering due to autoantibodies targeting desmoglein proteins, leading to acantholysis. This case report presents a 60-year-old Hispanic male patient with a history of hypertension who developed PV, initially presenting with pruritic scalp lesions that progressively spread to the nares, mouth, chest, neck, and inguinal region. Despite initial management with topical treatments, the lesions persisted, prompting hospitalization. Physical examination revealed characteristic skin and mucosal lesions, and a punch biopsy confirmed PV. The patient's management involved systemic corticosteroids and supportive care, resulting in significant improvement of the lesions. This case emphasizes the challenges in recognizing and managing PV. The symptom progression from isolated scalp involvement to multiple mucocutaneous sites highlights PV's clinical variability, which can complicate early recognition. Prompt diagnosis and a multidisciplinary approach are crucial for optimizing patient outcomes, preventing disease progression, and addressing the challenges posed by comorbid conditions.

Keywords: acantholysis; autoimmune disorder; corticosteroids; mucocutaneous; pemphigus vulgaris.

Figure 1. Physical examination reveals eroded skin and blistering across the limbs, torso, and scalp.

Figure 2. Physical examination reveals erosions on the oral mucosa and multiple lesions on the chest.