Erythromelanoderma with eosinophilic spongiosis and epidermal intercellular antibodies. Differentiation from pemphigus.

A patient with figurated, erythematous skin lesions which histologically showed eosinophilic spongiosis and an epithelial intercellular staining with IgG, but no acantholysis, developed erythromelanoderma. This case and a review of the pertinent literature indicate that the diagnosis of pemphigus does not seem to be justified even in the presence of eosinophilic spongiosis and epidermal intercellular antibodies, when the clinical signs of this disease and the typical histological feature, i.e., acantholysis, are lacking.