(BMJ)—A 67-yo woman presented w/ a 2-mo hx of a gradually growing lesion around her R eye. Exam: well-demarcated, periocular, eroded plaque w/ yellowish brown crusts. Bx confirmed the dx. What is it?
Bullous impetigo
Fogo selvagem
Pemphigus foliaceus
Mucormycosis
Erysipelas
You are correct. Histopathology showed superficial epidermal/intragranular acantholysis, and serum anti-Dsg1 Ab was slightly elevated, confirming the dx of localized pemphigus foliaceus, a rare autoimmune blistering dz. Dx can be challenging, but the condition is important to identify early, as dissemination could result in severe blistering and life-threatening skin infection.

BMJ 2020;368:m582