Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease

Pemphigus vegetans is a rare variant of deep acantholytic pemphigus which usually presents with vesiculobullous rash and vegetative plaques on the folds. We report a case of pemphigus vegetans patient who presented with rashes on tips of fingers and toes resembling paronychia and onychomadesis that...

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Main Authors: Thanisorn Sukakul, Supenya Varothai
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2018/5980937
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author Thanisorn Sukakul
Supenya Varothai
author_facet Thanisorn Sukakul
Supenya Varothai
author_sort Thanisorn Sukakul
collection DOAJ
description Pemphigus vegetans is a rare variant of deep acantholytic pemphigus which usually presents with vesiculobullous rash and vegetative plaques on the folds. We report a case of pemphigus vegetans patient who presented with rashes on tips of fingers and toes resembling paronychia and onychomadesis that misled the diagnosis for months. The final diagnosis of Hallopeau-type pemphigus vegetans was made based on histopathology and direct immunofluorescence studies. Interestingly, not only the clinical presentation was atypical, but blood tests for anti-desmoglein 1 and 3 antibodies by ELISA technique were also negative. Thus, the rare unusual manifestation of pemphigus vegetans in this patient may associate with different autoantibodies to desmosomal proteins compared with those of classic pemphigus patients.
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spelling doaj-art-6ca38650712d491c9f2f30aa9ceb61fb2025-08-20T03:34:09ZengWileyCase Reports in Medicine1687-96271687-96352018-01-01201810.1155/2018/59809375980937Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune DiseaseThanisorn Sukakul0Supenya Varothai1Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandPemphigus vegetans is a rare variant of deep acantholytic pemphigus which usually presents with vesiculobullous rash and vegetative plaques on the folds. We report a case of pemphigus vegetans patient who presented with rashes on tips of fingers and toes resembling paronychia and onychomadesis that misled the diagnosis for months. The final diagnosis of Hallopeau-type pemphigus vegetans was made based on histopathology and direct immunofluorescence studies. Interestingly, not only the clinical presentation was atypical, but blood tests for anti-desmoglein 1 and 3 antibodies by ELISA technique were also negative. Thus, the rare unusual manifestation of pemphigus vegetans in this patient may associate with different autoantibodies to desmosomal proteins compared with those of classic pemphigus patients.http://dx.doi.org/10.1155/2018/5980937
spellingShingle Thanisorn Sukakul
Supenya Varothai
Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease
Case Reports in Medicine
title Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease
title_full Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease
title_fullStr Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease
title_full_unstemmed Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease
title_short Chronic Paronychia and Onychomadesis in Pemphigus Vegetans: An Unusual Presentation in a Rare Autoimmune Disease
title_sort chronic paronychia and onychomadesis in pemphigus vegetans an unusual presentation in a rare autoimmune disease
url http://dx.doi.org/10.1155/2018/5980937
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