Pemphigus foliaceus. Early clinical appearance as dermatitis herpetiformis with eosinophilic spongiosis.

We encountered an unusual case of pemphigus foliaceus in which there were early clinical signs of dermatitis herpetiformis with eosinophilic spongiosis histologically. Numerous authors have appreciated that eosinophilic spongiosis occurs in early pemphigus foliaceus, usually in the preacantholytic stage when the lesions may clinically simulate dermatitis herpetiformis. Recognition of eosinophilic spongiosis may help differentiate early pemphigus from other vesiculobullous disorders.