Pemphigus vegetans of Hallopeau type. A case with a peculiar scalp localization [Pemfigo vegetante di Hallopeau. Un caso con singolare localizzazione al vertice]

The authors describe a case of pemphigus vegetans of Hallopeau type localized on the scalp. The patient showed a large ulceration on the scalp with humid and soft vegetant plaques, and peripherically several pustules. Differential diagnosis included: pyoderma gangrenosum, pyoderma follicolitis, and bromo/iododerma. Histology, direct and indirect immunofluorescence drove us to the diagnosis of P. vegetans Hallopeau type. The patient was treated with steroids (methylprednisone 0.8 mg/kg/day) and immunosuppressive drugs (azathioprinum 50 mg/day), and showed complete resolution within one month. The patient is actually in follow up with 8 mg every other day but the lesion resolved in a scar.