Case Number : Case 1798 - 19 April - Dr Hafeez Diwan Posted By: Guest

I am away for the next couple of days so am posting Dr Hafeez Diwan's excellent case a day early.

Cheers, Geoff Cross - DermpathPRO Projects

Acantholytic epidermal basal cells attached to dermal papillae, looking like a tombstone row or small intestine villi. Whereas the clinical presentantion is not flaccid blisters or erosions, but a rash, I go with urticarial pemphigus vulgaris.

PV

PV is a good differential! But I don't see any adnexal involvement and clinical description seems point at localised rash. 

How about a "papular acantholytic dermatosis of the genitocrural region"?

This is usually HH-like, but clinically could fit very well.

My first hypothesis wal also genital papular acantholytic dermatosis. A DIF may be of great help to differentiate it from PV.

Good posibility Vincenzo !!

Also thought of acantholytic dermatosis of the genitocrural area due to the clinical information and the localized aspect seen on the biopsy. Also, agree that IF could help.

Acantholytic dermatosis of the genitocrural region would be my first guess. But Hailey- Hailey, PV etc are in the differential. CPC/ DIF would help.....

Suprabasal without dyskeratosis or HH-like pattern. I'd have suggested in keeping with pemphigus, IMF studies needed to confirm though.

Acantholytic dermatosis of genitocrural region.