International Journal of Trichology International Journal of Trichology
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Year : 2013  |  Volume : 5  |  Issue : 3  |  Page : 157-158

Pemphigus vulgaris with loss of hair on the scalp

1 Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
2 Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

Correspondence Address:
Abraham Zlotogorski
Department of Dermatology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 9112001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-7753.125618

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Pemphigus vulgaris is an autoimmune disease, which leads to flaccid bullae and erosions. Although the scalp is commonly involved, hair loss is rarely seen. We herein report a case of 32-year-old female patient with a 2-year history of pemphigus vulgaris, involving the skin and mucosa. Although clinical improvement was achieved with oral corticosteroids and mycophenolate mofetil, the patient developed tender plaques on her scalp, accompanied by hair loss. Histopathology and direct immunofluorescence were consistent with pemphigus vulgaris. Skin swab cultured Staphylococcus aureus. Treatment with oral and topical corticosteroids combined with mycophenolate mofetil resulted in clinical remission, with regrowth of scalp hair. Alopecia is an unusual clinical manifestation of pemphigus vulgaris. Our case supports the hypothesis that hair loss is induced by antibody-mediated outer root sheath keratinocyte acantholysis, in combination with skin infection, that together lead to the observed hair loss.

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