We describe four patients with generalized scaly and pustular skin lesions
showing extensive neutrophilic infiltration in the subcorneal region of the
epidermis. Immunofluorescence, immunoblot and enzyme-linked immunosorbent
assay analyses detected IgG antibodies reacting exclusively with desmoglein
1, the pemphigus foliaceus antigen. This study indicates that pemphigus fo
liaceus may show prominent neutrophilic pustular skin lesions.