Supplementary Material for: Pemphigus vulgaris mimicking dyshidrotic eczema: A case report

INTRODUCTION
In this manuscript, we present a case of pemphigus vulgaris (PV) with unusual and rarely found clinical signs. We wrote this report to share information including clinical pictures and immunological test results during relapses with involvement of the scalp, metatarsus, and heels, as well as oral and genital mucous membranes in a patient with PV.

CASE REPORT
The study examined a patient with pemphigus-like lesions on the soles of both feet, scalp, and mucous membranes. The diagnosis was based on histopathology, direct and indirect immunofluorescence (DIF, IIF), ELISA, and mycology. Histopathological examination showed the presence of suprabasal acantholysis and acantholytic cells. DIF and IIF revealed IgG in the epidermal intercellular spaces of the epidermis. Circulating IgG antibodies reacted with dsg3 + and PV antigen, dsg1 (-) in ELISA. Mycology was negative. PV was diagnosed and treated with high doses of corticosteroids to maintain remission.

CONCLUSION
Pemphigus vulgaris may mimic dyshidrotic eczema. This is a rare case, in which differentiation between dyshidrotic eczema and PV required numerous tests, which should be performed in the differentiation of pompholyx from pemphigus vulgaris.