Pemphigus foliaceus (PF) is the second most common subtype among the pemphigus disorders, and is typically characterized by superficial, fragile bullae in a seborrheic distribution. We present a unique case of diffuse PF that mostly resolved with standard therapy but left a few recalcitrant thick "vegetative" plaques. While a psoriasiform presentation of pemphigus foliaceus has been reported, our findings may exist on a spectrum; to our knowledge, this is the first report of persistent "vegetative" lesions of PF in an otherwise classic presentation, raising important questions regarding the pathogenesis of this clinical variant.
Chernyak et al. (2026) studied this question.