salicylates and Acantholysis

A sixty-year-old man, developed 2-5 mm sized, hyperemic, itchy papules, vesicles, erosions and crusts on hyperemic base on his chest, abdomen, back, gluteal region, and proximal sites of his upper and lower extremities. The direct and indirect immunoflurescence tests were negative. Histology revealed extensive acantholysis in the epidermis in the following forms: pemphigus vulgaris-like suprabasal acantholysis, Darier-like acantholytic dyskeratosis with corps ronds, Hailey-Hailey-like suprabasal clefts, and pemphigus foliaceus-like superficial acantholysis with spongiosis. Using systemic steroids, topical drying, and reepithelising therapy, the patient was cured. He was symptom-free the first, fourth, and thirteenth months after finishing steroid therapy. We review the literature and the new subdivision of the disease according to the histological and clinical features.

Topics: Acantholysis; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Darier Disease; Dermatologic Agents; Epidermis; Fluorescent Antibody Technique, Direct; Fluorescent Antibody Technique, Indirect; Follow-Up Studies; Glucocorticoids; Humans; Hyperemia; Keratosis; Male; Merbromin; Middle Aged; Pemphigus; Pemphigus, Benign Familial; Prednisolone; Salicylates