Fogo selvagem

Synonym(s)

Endemic pemphigus foliaceus; Brazilian pemphigus; Brazilian pemphigus foliaceus; South American pemphigus

Definition

Variant of pemphigus foliaceus found in certain areas of Central America, South America, and Tunisia

Pathogenesis

Autoimmune disease, with autoantibodies specific for desmoglein, which results in acantholysis and linical blistering; black fly may be vector of spread

246 Follicular mucinosis

Clinical manifestation

Superficial vesicles that rupture easily and leave erosions; positive Nikolsky sign; occasional total body erythroderma; no mucous membrane involvement

Differential diagnosis

Impetigo; lupus erythematosus; pemphigus vulgaris; seborrheic dermatitis; atopic dermatitis; subcorneal pustular dermatosis; epidermolysis bullosa; glucagonoma syndrome; erythema multiforme Other causes of erythroderma: drug reaction; cutaneous T-cell lymphoma; psoriasis; pityriasis rubra pilaris; contact dermatitis

Therapy

Severe disease: prednisone; steroid sparing agents: azathioprine; cyclophosphamide; mycophenolate mofetil Mild-to-moderate disease: high potency topical corticosteroids

References

Sampaio SA, Rivitti EA, Aoki V, Diaz LA (1994) Brazilian pemphigus foliaceus, endemic pemphigus foliaceus, or fogo selvagem (wild fire). Dermatologic Clinics i2(4):765-776

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