Pemphigus Foliaceus: Report of 2 Cases / 대한피부과학회지

ABSTRACT

Pemphigus foliaceus is a chronic vesiculobullous dermatosis which seems to be an autoimmune etiology, and favorable results are usually able to obtain with massive doses of corticosteroids administration and Imuran or other anticancer drugs. Two cases of typical pemphigus foliaceus, who showed cutaneous candidiasis, one with clinical improvements, and the other one who had lung abscesses of aspergilli as a complication of the long-term corticosteroid treatment, have been presented. The diagnosis of pemphigus foliaceus was confirmed by histopathologically subcorneal bullae containing acantholytic cells, also Tzank test and Nikolsky's sign. First case, 37 year old man who has the history of corticostcroid therapy for 3 years tor rheumatoid arthritis, was treated with high dosage of prednisolone and antibiotics with nystatin for cutaneous candidiasis, but lung abscesses of aspergilli developed while we couldn't even notice its progress and he died suddenly because of it although skin lesions showed marked improvement. Second case, 36 year old house wife who has the history of recurrent aphthous stomatitis like eruptions was recovered from pemphigus foliceus after steroid treatment and cutaneous candidiasis after using antibiotics and nystatin. As the complication of corticosteroid therapy, cushingoid feature, blurred vision, and cutaneous candidiasis were occurred in both patients, especially in the first case, hyperglycemia and metabolic alkaloses were developed. And so, as mention of Saunders, we checked the patient's complete history, body weight everyday, and CBC and occult blood every week, but urine sugar or blood sugar and chest X-ray not periodically. We used anabolic agent for osteoporosis, antibiotics, mycostatm, diuretics, and antacid regimen, but failed to deveIopment of aspergillosis.