Pemphigus foliaceus unveiled: a case report

Abstract Pemphigus foliaceus is a rare, life-threatening autoimmune skin disorder characterized by acantholysis (loss of keratinocyte-to-keratinocyte adhesion), which causes blistering and erosion of the skin. P. foliaceus is a less common type of Pemphigus that affects 0.5 to 3.2 million people worldwide, with a higher prevalence in women aged 40–60. We present a case of a 75-year-old man who initially developed blisters on his scalp, which went unrecognized for three months due to the absence of prompt medical evaluation. As a result, the lesions progressively spread across his body, causing severe itching and fluid-filled erosions. A skin biopsy revealed subcorneal bullae with a few neutrophils and dyskeratotic acantholytic cells, confirming the diagnosis. This case highlights the critical importance of early recognition and intervention, as a delay in diagnosis can lead to disease progression and poorer outcomes. A multidisciplinary management approach, including systemic therapy and supportive care, is essential for improving prognosis in such patients.