Pemphigus Foliaceus with Secondary Pseudomonas Aeruginosa Infection and Steroid-induced Hyperglycemia: a Case Report

Pemphigus foliaceus (PF) is a rare autoimmune blistering disorder caused by Immunoglobulin G (IgG) autoantibodies against desmoglein-1(Dsg-1), leading to superficial skin erosions without mucosal involvement. We report a case of a 71-year-old female who presented with flaccid blisters and crusted erosions over chest, back, neck, scalp, and face. A skin biopsy confirmed PF with subcorneal blister formation and Tzanck smear revealed acantholytic cells, supporting the diagnosis. She developed secondary Pseudomonas aeruginosa infection and steroid-induced hyperglycemia during treatment. Management included intravenous corticosteroids, targeted antibiotics, wound care, and monitoring of electrolytes and glucose levels. This case highlights the importance of early diagnosis, infection surveillance, and multidisciplinary care in PF to prevent complications and improve outcomes.