PMC5726697_01
(A) Erythema and scaling on the abdominal region.
(B) Peripheral pustules. (C) and
(D) Clinical worsening after corticosteroid tapering:
confluent pustules over an erythematous base
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f1
Thus, the prednisone dose was increased (80 mg/day), but there was no improvement and he developed pustular lesions and fever spikes (Figure 1). We continued to taper the corticosteroid slowly, but he had a new flare of the pustular lesions when prednisone dose was lowered to 10mg/day (Figure 1).
A, B and C: Extensive acantholysis in the upper layers of
the epidermis (Hematoxylin & eosin; A: X100, B: X100 and C: X400).
D: Direct immunofluorescence demonstrating the
deposition of intrapidermal, intercellular IgG (X400)
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f2
New biopsies with samples for DIF were performed, that confirmed the diagnosis of PF (Figure 2).