Dyshydrosiform Immunoglobulin A Pemphigus: An Uncommon Yet Intriguing Case Report

A 24-year-old female presented with relapsing and remitting, fluid-filled lesions on her palms and soles for 2 years. These lesions, which began as vesiculopustules, coalesced into larger plaques and eventually led to post-inflammatory hyperpigmentation. Histopathology revealed hyperkeratosis, subcorneal pustules and neutrophilic exudates, while direct immunofluorescence demonstrated intercellular immunoglobulin A (IgA) deposits in the upper epidermis. These findings were suggestive of dyshydrosiform subcorneal pustular dermatosis-type IgA pemphigus, a rare autoimmune blistering disorder. Treatment with dapsone led to significant clinical improvement within 2 months. IgA pemphigus is a chronic condition with a wide clinical spectrum. The involvement of acral sites, as seen in this case, is an uncommon presentation, emphasising the need for further investigation into the pathogenesis and variability of this rare entity.