clobetasol and Acantholysis

Topics: Acantholysis; Administration, Cutaneous; Adult; Arm; Clobetasol; Female; Glucocorticoids; Humans; Leg; Neutrophils; Pemphigus; Torso; Treatment Outcome

The fact that this patient's rash was limited to his chest provided an important diagnostic clue.

Topics: Acantholysis; Acneiform Eruptions; Administration, Oral; Administration, Topical; Biopsy; Clobetasol; Dermatitis, Seborrheic; Dermatologic Agents; Diagnosis, Differential; Drug Eruptions; Folliculitis; Histamine Antagonists; Humans; Ichthyosis; Male; Middle Aged; Skin; Terfenadine; Treatment Outcome

Topics: Acantholysis; Aged; Anti-Inflammatory Agents; Clobetasol; Dyssomnias; Humans; Ichthyosis; Male; Prednisolone; Pruritus

A 77-year-old man was seen with florid, vegetating nodules in the umbilical, axillary and inguinal areas, scaly erythema in the trunk and fragile nails. Histologically, marked to moderate acanthosis and papillomatosis with intraepidermal abscesses composed of acantholytic cells, eosinophils and neutrophils were seen in the vegetating lesions which showed intercellular IgG deposit by the direct immunofluorescence technique. There were no circulating pemphigus antibodies. The lesions were successfully treated by topical corticosteroids. However, flaccid bullae with hypopyon showing subcorneal acantholysis and intercellular IgG deposits continued to develop. After 3 1/2 years, circulating pemphigus antibody of IgG2 subclass was demonstrated.

Topics: Acantholysis; Administration, Topical; Aged; Anti-Inflammatory Agents; Betamethasone; Clobetasol; Fluorescent Antibody Technique; Glucocorticoids; Humans; Immunoglobulin G; Male; Pemphigus