Open AccessExfoliative dermatitis causing diagnostic dilemma: Sibling provides the missing link
Author(s) -
Soumya Jagadeesan,
Malini Eapen,
Aditi Karunakaran,
Vinitha Varghese Panicker,
Gopikrishnan Anjaneyan,
Lekshmi Sajini,
Sreedevan Velayudhan,
Jacob Thomas
Publication year - 2020
Publication title -
journal of skin and sexually transmitted diseases./journal of skin and sexually transmitted diseases
Language(s) - English
Resource type - Journals
eISSN - 2994-6026
pISSN - 2582-3175
DOI - 10.25259/jsstd_36_2019
Subject(s) - acantholysis , erythroderma , medicine , dermatology , pathological , biopsy , pathology , immunology , autoantibody , antibody
A 49-year-old male presented with erythroderma of 3-month duration with a flexural onset. No mucosal lesions were present, and skin biopsy showed features of acantholysis and suprabasal clefting. Direct immunofluorescence test was negative in repeated examinations. The patient was presumptively managed as pemphigus foliaceus with immunomodulators though the level of split was suprabasal rather than subcorneal, and the patient responded well to the treatment. However, his elder sister presented to the department with clinical and histopathological features of classical Hailey–Hailey disease (HHD) which resembled the pathological features found in the index case. This prompted us to review the diagnosis and retrospectively diagnose the index case as HHD presenting with erythroderma.