Pemphigus foliaceus with prominent neutrophilic pustules initially presenting as erythroderma.

We report a 64-year-old man who presented with generalized erythroderma and erosions. The erythroderma improved generally as a result of systemic prednisolone treatment. After treatment, however, the patient developed annular erythema with tiny pustules. Histopathology, ELISA and immunoblot analysis showed the disease to be pemphigus foliaceus (PF) with prominent neutrophilic pustules. To our knowledge, this is the first known case of PF with prominent neutrophilic pustules presenting as erythroderma.