A case of pemphigus foliaceus which occurred after five years of remissionfrom pemphigus vulgaris

A 77-year-old Japanese female developed pemphigus foliaceus (PF) after 5 ye ars of remission from pemphigus vulgaris (PV). The patient had painful eros ions in her mouth and flaccid blisters of the skin and was diagnosed as hav ing PV, which responded well to corticosteroid treatment. She was then free from any lesion of PV for 5 years with a low dose of corticosteroid. Then she developed scaly erythematous lesions on the skin and was diagnosed as s uffering from PF. Enzyme-linked immunosorbent assay (ELISA) using recombina nt desmoglein 1 (Dsg-1) and Dsg-3 revealed that she had anti-Dsg-3 IgG in t he PV stage, no antibodies during remission and anti-Dsg-1 IgG in the PF st age. These findings indicate that the target antigen was shifted from Dsg-3 to Dsg-1 along with the phenotype after a 5-year interval in this patient. Copyright (C) 2001 S. Karger AG, Basel.