Childhood pemphigus foliaceus: case report and review of the literature

Childhood pemphigus foliaceus typically causes erythema and scaling of the scalp. Sometimes, blisters and oozing are present, which often are misdiagnosed as either impetigo or seborrheic dermatitis. The eruption may progress to involve the trunk and limbs, the lesions often having an arcuate pattern. The diagnosis can be established by histologic and immunologic evaluation. In children, the disease seems to be less severe than pemphigus vulgaris, as is the case with adults, and we recommend a trial of topical steroids before embarking on systemic therapy.

[Pemphigus vulgaris in childhood]

Histological examination and immunofluorescence technique revealed the clinical diagnosis 'Erythema exudativum multiforme' as a real Pemphigus vulgaris of a 14-year-old boy. Early diagnosis and a large dose therapy of immunosuppressives agents decide on the survival of the patients.

HLA-DR antigens in pemphigus among Japanese

The frequency of HLA-DR4 was significantly increased at P less than 0.02 in 37 unrelated pemphigus patients (62.2%), when compared with unrelated 73 healthy controls (30.1%). This antigen was more frequently found in pemphigus foliaceus (70.6%) than pemphigus vulgaris (55.8%).

Pemphigus in Hartford County, Connecticut, from 1972 to 1977

An investigation of a possible cluster of pemphigus cases that were diagnosed in Hartford County, Connecticut, in 1977 provided data for estimating the incidence of this disease in a defined population for the years 1972 to 1977. The average annual incidence (new cases per population per year) estimated for the overall adult population (over the age of 20 years) was 0.42 cases per 100,000 people, whereas that for Jewish adults was 3.2 cases per 100,000. Thus, the results of this report both support the hypothesis that Jewish people are at higher risk than others for the development of pemphigus and provide a basis for comparison with the results of other studies of this disease.

HLA-DRw4 in pemphigus vulgaris patients in Israel

Pemphigus vulgaris (PV) is relatively common in Jews. Three HLA antigens were significantly more frequent in 39 Israeli Jewish PV patients than in controls A26 - 59% vs 20%; Bw38 - 61% vs 20%; and DRw4 - 90% vs 38%. The joint occurrence of A26-Bw38-DRw4 was observed in 46% of PV patients and in 10% of controls. Similar results were recently reported for Jews in the Los Angeles area. Yet, when our patient sample was grouped into Ashkenazi and non-Ashkenazi Jews, it was evident that each of the three antigens had a higher frequency both in Ashkenazi patients and controls as compared to non-Ashkenzai. The relative risk for DRw-4 in Ashkenzim was 33.8 as compared to 14.4 in the total sample of Israeli PV patients. The phenotype A26-Bw38-DRw4 was present in 57% of Ashkenazi patients and in 13% of controls. Ashkenazi Jews have the highest prevalence of PV, and HLA associations were strongest with Ashkenazi PV patients. These associations were with three antigens, all of high frequency in that group.

Pemphigus in El Salvador. An eight-year study (1970-1977)

Of 23 patients with pemphigus seen between 1970 and 1977, 18 had foliaceus and five had vulgaris (ratio of 3.73:1). The characteristics of pemphigus foliaceus (age of onset, disease among sisters, presence of lesions resistant to corticotherapy) suggest Brazilian pemphigus foliaceus (fogo selvagem).