Challenging the limits: an unusual case of pemphigus foliaceus in a pediatric patient

Pemphigus foliaceus (PF) is an autoimmune blistering dermatosis characterized by the formation of intraepidermal blisters with acantholysis and the presence of autoantibodies directed against desmoglein 1. Clinically, it manifests as small superficial blisters or vesicles that rapidly evolve into scaly and crusted erosions, typically distributed in seborrheic areas such as the scalp, face, and central trunk, usually without mucosal involvement. We present the clinical case of a pediatric patient from southwestern Colombia diagnosed with pemphigus foliaceus, aiming to illustrate the clinical and histopathological characteristics of this uncommon disease in an age group where its presentation is rare. The importance of early diagnosis and timely management of this condition is emphasized to prevent severe complications, highlighting the diagnostic challenge posed by PF, especially in the pediatric population, where its atypical presentation can lead to initial therapeutic misjudgements and potentially fatal complications.